G0011 Medicaid reimbursement rate by state (2026)
Individual counseling for pre-exposure prophylaxis. Medicaid pays a median of $23.12 for G0011 across 20 states, from $3.47 in New Jersey to $41.32 in Montana.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 20
- National median
- $23.12units vary by state
- Lowest
- $3.47New Jersey
- Highest
- $41.32Montana
What does Medicaid pay for G0011?
20 state Medicaid programs publish a fee-for-service rate for G0011 at the physician psychologist level. The national median is $23.12 (units differ between states). Montana pays the most, $41.32, and New Jersey the least, $3.47, a 11.9x spread.
Medicare (non-facility, 2026 physician fee schedule): $27.48–$36.18 depending on the state's Medicare locality.
G0011 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 20 states with every variant, modifier and effective date.
Frequently asked questions
What does Medicaid pay for G0011?
It depends on the state. Of the 20 states with a published fee-for-service rate, the median is $23.12. Montana pays the most ($41.32) and New Jersey the least ($3.47).
Which state pays the highest Medicaid rate for G0011?
Montana, at $41.32, effective 2026-07-01.
Do managed-care plans pay the same rate for G0011?
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.