G0561 Medicaid reimbursement rates by state
Tympanostomy with local or topical anesthesia and insertion.... 10 state Medicaid programs publish a fee-for-service rate for G0561 at the physician psychologist level. Rates run from $30.00 in California to $773.33 in Missouri, with a median of $393.78.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 10
- Median rate
- $393.78units vary by state
- Highest
- $773.33Missouri
- Medicare (non-facility)
- —not on the physician fee schedule
G0561 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 |
|---|---|---|---|---|---|---|
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $773.33since 2025-10-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Practitioner |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $675.00since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $674.75since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $623.66since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Practitioner Fee Schedule (2026-01-01) |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $623.66since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Physician fee schedule (2026 |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $163.90since 2026-04-01 | — | — | 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) | $90.00since 2025-01-01 | percent of billed charges | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $86.78since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $85.67since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $30.00since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal UA and UB Modifier Maximum Allo |
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 G0561?
It depends on the state. Of the 10 states with a published fee-for-service rate, the median is $393.78. Missouri pays the most ($773.33) and California the least ($30.00).
Which state pays the highest Medicaid rate for G0561?
Missouri, at $773.33, effective 2025-10-01.
Do managed-care plans pay the same rate for G0561?
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.