S0621 Medicaid reimbursement rates by state
Routine ophthalmological examination including refraction. 5 state Medicaid programs publish a fee-for-service rate for S0621 at the physician psychologist level. Rates run from $41.82 in Texas to $69.20 in Delaware, with a median of $59.29.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 5
- Median rate
- $59.29units vary by state
- Highest
- $69.20Delaware
- Medicare (non-facility)
- —not on the physician fee schedule
S0621 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 |
|---|---|---|---|---|---|---|
| DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP) | $69.20since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | DMAP 2024 Physician Fee Schedule |
| ArkansasPhysician or licensed psychologist (incl. BCBA-D) · Arkansas Medicaid (fee-for-service) | $60.23since 2025-06-13 | — | — | Not classified | — | Arkansas Medicaid Physician / CRNA / Fam |
| North CarolinaPhysician or licensed psychologist (incl. BCBA-D) · North Carolina Medicaid Direct (fee-for-service) | $59.29since 2025-10-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Physician Serv |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $57.72since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Vision Fee Schedule database, Janu |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $41.82since 2023-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
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 S0621?
It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $59.29. Delaware pays the most ($69.20) and Texas the least ($41.82).
Which state pays the highest Medicaid rate for S0621?
Delaware, at $69.20, effective 2024-01-01.
Do managed-care plans pay the same rate for S0621?
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.