99172 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 12 state Medicaid programs publish a fee-for-service rate for 99172 at the agency level. Rates run from $5.50 in Maryland to $97.71 in Oregon, with a median of $14.79.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 12
- Median rate
- $14.79units vary by state
- Highest
- $97.71Oregon
- Medicare (non-facility)
- —not on the physician fee schedule
99172 rate in every state
One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $97.71⚠ over 3× mediansince 2025-01-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $73.16⚠ over 3× mediansince 2013-02-01 | — | — | Plans must pay at least this | — | Louisiana Medicaid Professional Services |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $50.64⚠ over 3× mediansince 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $36.56since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $15.64since 2020-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Physician fee schedule (2020 |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $15.41since 2008-01-01 | — | — | Not classified | — | CMAP fee schedule: Physician Office and |
| IowaAgency provider · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $14.16since 2018-09-01 | — | — | Paid by the state, outside plans | — | Iowa Medicaid fee schedule #40 AREA EDUC |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $13.89since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $12.53since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $9.89since 2023-10-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Local Health Department, October 2 |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $8.07since 2018-01-01 | — | — | Plans negotiate; applies out of network | — | Appendix DD to OAC 5160-1-60 (Non-Instit |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $5.50since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.
Frequently asked questions
What does Medicaid pay for 99172?
It depends on the state. Of the 12 states with a published fee-for-service rate, the median is $14.79. Oregon pays the most ($97.71) and Maryland the least ($5.50).
Which state pays the highest Medicaid rate for 99172?
Oregon, at $97.71, effective 2025-01-01.
Do managed-care plans pay the same rate for 99172?
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 table shows the rule for each state, cited to the contract or statute.