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Billing code 01999 · Physician & professional

01999 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $25.04 for 01999 across 10 states, from $0.96 in Idaho to $87.81 in Florida.

Data as of Oct 5, 202610 statesEvery rate links to its official source

States publishing
10
National median
$25.04units vary by state
Lowest
$0.96Idaho
Highest
$87.81Florida
Answer

What does Medicaid pay for 01999?

10 state Medicaid programs publish a fee-for-service rate for 01999. The national median is $25.04 (units differ between states). Florida pays the most, $87.81, and Idaho the least, $0.96 per minute, a 91.5x spread.

State ranking

01999 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 10 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Florida Source · since 2026-01-01$87.81——Plans negotiate; applies out of network—
2Iowa Source · since 2012-06-11$45.00——Plans must pay at least this—
3Oregon Source · since 2026-01-01$44.08——Plans negotiate; applies out of network—
5Missouri Source · since 2025-07-01$27.27——Plans must pay at least this—
6Hawaii Source · since 2024-03-04$22.80——Plans negotiate; applies out of network—
9Maine Source · since 2026-01-01$10.73——Not classified—
10Idaho Source · since 2025-09-01$0.96minute—Not classified—
See all 10 states for 01999 — start free

3 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.

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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 01999 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 01999, 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. 4 of the 10 states list more than one rate for 01999, 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 10 states, 1 publish 01999 per minute, and 9 schedules print no unit at all (a flat amount per service).
  • Per hour. 01999 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 01999, 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 01999 rates differ between states

Published rates for 01999 run from $0.96 in Idaho to $87.81 in Florida. The two publish it in different units (no unit printed versus minute), so part of that gap is the unit rather than the price. Half the states pay more than the median of $25.04 and half pay less. The usual reasons for a spread like this in physician & professional rates:

  • Modifiers such as professional or technical component, bilateral, multiple procedure and assistant at surgery change the amount paid, and states apply them with their own percentages.
  • Some states pay physician services as a percentage of the Medicare fee schedule; others keep a schedule of their own that may not have been rebased for years.
  • 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.

Timing matters too. 4 states set the current rate for 01999 in 2026 or later, while 2 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 01999

What a plan pays for 01999 is negotiated privately, but the state decides how much room there is to negotiate. Here is how the rules break down across the 10 states.

In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 5 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 (5 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 (2 states). 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 Florida managed care.

Billing

Units and billing for 01999

01999 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.

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. Where a state publishes separate facility and non-facility amounts, the non-facility (office) amount is usually higher because the practice carries the overhead.

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 01999?

It depends on the state. Of the 10 states with a published fee-for-service rate, the median is $25.04. Florida pays the most ($87.81) and Idaho the least ($0.96 per minute).

Which state pays the highest Medicaid rate for 01999?

Florida, at $87.81, effective 2026-01-01.

Which state pays the lowest Medicaid rate for 01999?

Idaho, at $0.96 per minute, effective 2025-09-01. It publishes the code in a different unit from Florida, so compare per unit with care.

What unit is 01999 billed in?

Of the 10 states, 1 publish 01999 per minute, and 9 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for 01999?

Not necessarily. In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 5 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.