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97811 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $18.79 for 97811 across 10 states, from $10.66 in Oregon to $22.34 in Maryland.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
10
National median
$18.79units vary by state
Lowest
$10.66Oregon
Highest
$22.34Maryland

What does Medicaid pay for 97811?

10 state Medicaid programs publish a fee-for-service rate for 97811. The national median is $18.79 (units differ between states). Maryland pays the most, $22.34, and Oregon the least, $10.66 per 15 min, a 2.1x spread.

Medicare (non-facility, 2026 physician fee schedule): $27.35–$34.93 depending on the state's Medicare locality.

97811 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 10 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Maryland Source · since 2026-01-01$22.34——Not classified—
2Minnesota Source · since 2026-02-01$21.35——Plans negotiate; applies out of network—
3California Source · since 2026-10-01$20.00——Plans negotiate; applies out of network—
5Massachusetts Source · since 2026-10-01$19.20——Plans negotiate; applies out of network—
6Ohio Source · since 2024-01-01$18.38——Plans negotiate; applies out of network—
9New Jersey Source · since 2026-07-01$12.20——Not classified—
10Oregon Source · since 2024-07-01$10.6615 min$42.64Plans negotiate; applies out of network—
See all 10 states for 97811 — start free

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Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track 97811 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
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Frequently asked questions

What does Medicaid pay for 97811?

It depends on the state. Of the 10 states with a published fee-for-service rate, the median is $18.79. Maryland pays the most ($22.34) and Oregon the least ($10.66 per 15 min).

Which state pays the highest Medicaid rate for 97811?

Maryland, at $22.34, effective 2026-01-01.

Do managed-care plans pay the same rate for 97811?

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.

Related codes

Codes next to 97811

97755Physician and practitioner services (fee schedule) · 29 states97799Physician and practitioner services (fee schedule) · 9 states97804Physician and practitioner services (fee schedule) · 32 states97810Physician and practitioner services (fee schedule) · 11 states97813Physician and practitioner services (fee schedule) · 11 states97814Physician and practitioner services (fee schedule) · 11 states98000Physician and practitioner services (fee schedule) · 18 states98001Physician and practitioner services (fee schedule) · 18 states

Most-published Physician & professional codes

10005Physician and practitioner services (fee schedule) · 50 states10006Physician and practitioner services (fee schedule) · 50 states10007Physician and practitioner services (fee schedule) · 50 states10008Physician and practitioner services (fee schedule) · 50 states10009Physician and practitioner services (fee schedule) · 50 states10010Physician and practitioner services (fee schedule) · 50 states10021Physician and practitioner services (fee schedule) · 50 states10030Physician and practitioner services (fee schedule) · 50 states

Highest-paying states

Maryland Medicaid fee scheduleMinnesota Medicaid fee scheduleCalifornia Medicaid fee schedule