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Billing code 10005 · Physician & professional

10005 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $87.59 for 10005 across 50 states, from $14.82 in Rhode Island to $220.83 in Alaska.

Data as of Oct 5, 202650 statesEvery rate links to its official source

States publishing
50
National median
$87.59units vary by state
Lowest
$14.82Rhode Island
Highest
$220.83Alaska
Answer

What does Medicaid pay for 10005?

50 state Medicaid programs publish a fee-for-service rate for 10005. The national median is $87.59 (units differ between states). Alaska pays the most, $220.83, and Rhode Island the least, $14.82, a 14.9x spread.

Medicare (non-facility, 2026 physician fee schedule): $118.35–$169.84 depending on the state's Medicare locality.

State ranking

10005 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 50 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Alaska Source · since 2026-07-01$220.83——Not classified—
2Alabama Source · since 2026-09-24$192.91——Not classified—
3Montana Source · since 2026-07-01$185.92——Not classified—
25Wisconsin Source · since 2019-01-01$88.43——Plans negotiate; applies out of network—
26New Hampshire Source · since 2023-07-01$86.75——Plans negotiate; applies out of network—
27Michigan Source · since 2026-01-01$84.35——Plans negotiate; applies out of network—
49Arkansas Source · since 2025-06-13$28.31——Not classified—
50Rhode Island Source · since 2019-01-01$14.82——Plans negotiate; applies out of network—
See all 50 states for 10005 — start free

42 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 10005 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
FAQ

Frequently asked questions

What does Medicaid pay for 10005?

It depends on the state. Of the 50 states with a published fee-for-service rate, the median is $87.59. Alaska pays the most ($220.83) and Rhode Island the least ($14.82).

Which state pays the highest Medicaid rate for 10005?

Alaska, at $220.83, effective 2026-07-01.

Do managed-care plans pay the same rate for 10005?

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 workspace shows the rule for each state, cited to the contract or statute.