97610 Medicaid reimbursement rate by state (2026)
Physician and practitioner services (fee schedule). Medicaid pays a median of $210.53 for 97610 across 22 states, from $11.67 in Illinois to $574.12 in New Mexico.
- States publishing
- 22
- National median
- $210.53units vary by state
- Lowest
- $11.67Illinois
- Highest
- $574.12New Mexico
What does Medicaid pay for 97610?
22 state Medicaid programs publish a fee-for-service rate for 97610. The national median is $210.53 (units differ between states). New Mexico pays the most, $574.12, and Illinois the least, $11.67, a 49.2x spread. Where the billing unit matches Medicare's, Medicaid pays 38% of the 2026 Medicare physician fee schedule amount for the state.
Medicare (non-facility, 2026 physician fee schedule): $343.99–$472.49 depending on the state's Medicare locality.
97610 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 22 states with every variant, modifier and effective date.
Frequently asked questions
What does Medicaid pay for 97610?
It depends on the state. Of the 22 states with a published fee-for-service rate, the median is $210.53. New Mexico pays the most ($574.12) and Illinois the least ($11.67).
Which state pays the highest Medicaid rate for 97610?
New Mexico, at $574.12, effective 2025-01-01.
How do Medicaid rates for 97610 compare with Medicare?
Where the billing units match, Medicaid pays 38% of the 2026 Medicare physician fee schedule amount for the state (non-facility).
Do managed-care plans pay the same rate for 97610?
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.