95869 Medicaid reimbursement rate by state (2026)
Physician and practitioner services (fee schedule). Medicaid pays a median of $48.17 for 95869 across 49 states, from $12.03 in Kentucky to $111.71 in Alaska.
- States publishing
- 49
- National median
- $48.17units vary by state
- Lowest
- $12.03Kentucky
- Highest
- $111.71Alaska
What does Medicaid pay for 95869?
49 state Medicaid programs publish a fee-for-service rate for 95869. The national median is $48.17 (units differ between states). Alaska pays the most, $111.71, and Kentucky the least, $12.03 per visit, a 9.3x spread. Where the billing unit matches Medicare's, Medicaid pays 14% of the 2026 Medicare physician fee schedule amount for the state.
Medicare (non-facility, 2026 physician fee schedule): $83.12–$132.37 depending on the state's Medicare locality.
95869 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 95869?
It depends on the state. Of the 49 states with a published fee-for-service rate, the median is $48.17. Alaska pays the most ($111.71) and Kentucky the least ($12.03 per visit).
Which state pays the highest Medicaid rate for 95869?
Alaska, at $111.71, effective 2026-07-01.
How do Medicaid rates for 95869 compare with Medicare?
Where the billing units match, Medicaid pays 14% of the 2026 Medicare physician fee schedule amount for the state (non-facility).
Do managed-care plans pay the same rate for 95869?
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.