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Billing code 01936 · Physician & professional

01936 Medicaid reimbursement rate by state (2026)

Anesthesia base units (per procedure). Medicaid pays a median of $16.13 for 01936 across 6 states, from $1.29 in Maryland to $75.00 in Idaho.

Data as of Oct 5, 20266 statesEvery rate links to its official source

States publishing
6
National median
$16.13units vary by state
Lowest
$1.29Maryland
Highest
$75.00Idaho
Answer

What does Medicaid pay for 01936?

6 state Medicaid programs publish a fee-for-service rate for 01936. The national median is $16.13 (units differ between states). Idaho pays the most, $75.00 per base unit, and Maryland the least, $1.29 per minute, a 57.9x spread.

State ranking

01936 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 6 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Idaho Source · since 2025-01-01$75.00base unit—Not classified—
2Arizona Source · since 2020-10-01$32.12——Plans negotiate; applies out of network—
3Colorado Source · since 2021-07-01$27.25——Not classified—
6Maryland Source · since 2026-01-01$1.29minute—Not classified—
See all 6 states for 01936 — start free

2 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

  • Source for every rate
  • Full rate history
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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; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track 01936 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
Guide

How to read this table

  • Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for 01936, so the order is by published amount and is not a like-for-like rank.
  • Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 1 of the 6 states list more than one rate for 01936, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
  • Unit. Of the 6 states, 3 publish 01936 per base unit and 1 per minute, and 2 schedules print no unit at all (a flat amount per service).
  • Per hour. 01936 is not billed in time units in these states, so no hourly figure is shown.
  • Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
  • % of Medicare. No Medicare physician fee schedule amount is on file for 01936, so there is no percentage.
  • Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Context

Why 01936 rates differ between states

Published rates for 01936 run from $1.29 in Maryland to $75.00 in Idaho. The two publish it in different units (base unit versus minute), so part of that gap is the unit rather than the price. Half the states pay more than the median of $16.13 and half pay less. The usual reasons for a spread like this in physician & professional rates:

  • Primary-care and pediatric add-ons, enhanced rates for certain specialties and targeted increases for access problems change individual codes without moving the rest of the schedule.
  • Many schedules pay differently by place of service (office versus facility) and by practitioner, and nurse practitioners and physician assistants are often paid a percentage of the physician amount.
  • Each state sets its own physician conversion factor or fee for every code, and many update them on a state budget cycle rather than on Medicare's calendar.

Timing matters too. 1 state set the current rate for 01936 in 2026 or later, while 3 states still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.

Managed care

What managed-care plans pay for 01936

No managed-care plan publishes what it pays for 01936. What is public is the rule each state's plan contracts set, and that rule decides how much the published rate matters when you contract with a plan.

In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 2 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 3 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (2 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.
  • Plans must pay at least the published rate (1 state). The published rate is your floor. Negotiate up from it, and if a plan pays less, the contract provision is the basis for a payment dispute.

Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example Idaho managed care.

Billing

Units and billing for 01936

01936 is a CPT anesthesia code in the physician & professional line, billed mostly by physicians, nurse practitioners, physician assistants and other licensed practitioners. Anesthesia is commonly paid on base units plus time units multiplied by a conversion factor, so a published amount can be a base value or a conversion factor rather than a full payment. Read the unit column before comparing.

Physician-fee-schedule codes are billed per service: one unit is one occurrence unless the code itself is defined by time or quantity. Practitioners who are not physicians are often paid a reduced percentage of the published amount, so check the schedule for the reduction that applies to your provider type.

Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.

FAQ

Frequently asked questions

What does Medicaid pay for 01936?

It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $16.13. Idaho pays the most ($75.00 per base unit) and Maryland the least ($1.29 per minute).

Which state pays the highest Medicaid rate for 01936?

Idaho, at $75.00 per base unit, effective 2025-01-01.

Which state pays the lowest Medicaid rate for 01936?

Maryland, at $1.29 per minute, effective 2026-01-01. It publishes the code in a different unit from Idaho, so compare per unit with care.

What unit is 01936 billed in?

Of the 6 states, 3 publish 01936 per base unit and 1 per minute, and 2 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for 01936?

Not necessarily. In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 2 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 3 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.