95004 Medicaid reimbursement rate by state (2026)
Physician and practitioner services (fee schedule). Medicaid pays a median of $3.12 for 95004 across 49 states, from $0.96 in Rhode Island to $9.16 in Alabama.
- States publishing
- 49
- National median
- $3.12units vary by state
- Lowest
- $0.96Rhode Island
- Highest
- $9.16Alabama
What does Medicaid pay for 95004?
49 state Medicaid programs publish a fee-for-service rate for 95004. The national median is $3.12 (units differ between states). Alabama pays the most, $9.16, and Rhode Island the least, $0.96, a 9.5x spread.
Medicare (non-facility, 2026 physician fee schedule): $3.09–$4.88 depending on the state's Medicare locality.
95004 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 49 states with every variant, modifier and effective date.
Frequently asked questions
What does Medicaid pay for 95004?
It depends on the state. Of the 49 states with a published fee-for-service rate, the median is $3.12. Alabama pays the most ($9.16) and Rhode Island the least ($0.96).
Which state pays the highest Medicaid rate for 95004?
Alabama, at $9.16, effective 2026-09-24.
Do managed-care plans pay the same rate for 95004?
Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The workspace shows the rule for each state, cited to the contract or statute.