G0421 Medicaid reimbursement rates by state
Face-to-face educational services related to the care of.... 8 state Medicaid programs publish a fee-for-service rate for G0421. Rates run from $5.04 in Kansas to $25.86 in New Mexico, with a median of $20.54.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 8
- Median rate
- $20.54units vary by state
- Highest
- $25.86New Mexico
- Medicare (non-facility)
- $25.96–$30.062026 physician fee schedule
G0421 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 |
|---|---|---|---|---|---|---|
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $25.86since 2023-07-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $23.98since 2026-01-01 | — | — | Plans must pay at least this | — | Louisiana Medicaid Enhanced Professional |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $21.94since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $20.58since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $20.50since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $17.47since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Practitioner and Medical Clinic Fe |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $11.73since 2026-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $5.04since 2010-01-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
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 G0421?
It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $20.54. New Mexico pays the most ($25.86) and Kansas the least ($5.04).
Which state pays the highest Medicaid rate for G0421?
New Mexico, at $25.86, effective 2023-07-01.
Do managed-care plans pay the same rate for G0421?
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.