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Billing code 99374 · Physician & professional

99374 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $45.64 for 99374 across 11 states, from $33.97 in Virginia to $96.86 in New Mexico.

Data as of Oct 5, 202611 statesEvery rate links to its official source

States publishing
11
National median
$45.64units vary by state
Lowest
$33.97Virginia
Highest
$96.86New Mexico
Answer

What does Medicaid pay for 99374?

11 state Medicaid programs publish a fee-for-service rate for 99374. The national median is $45.64 (units differ between states). New Mexico pays the most, $96.86, and Virginia the least, $33.97, a 2.9x spread.

State ranking

99374 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 11 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1New Mexico Source · since 2025-01-01$96.86——Plans must pay at least this—
2Alabama Source · since 2016-10-01$66.49——Not classified—
3Wyoming Source · since 2026-07-01$66.13——Not classified—
5Texas Source · since 2023-09-01$57.33——Plans negotiate; applies out of network—
6Nevada Source · since 2015-07-01$45.64——Plans must pay at least this—
10Massachusetts Source · since 2026-10-01$39.85——Plans negotiate; applies out of network—
11Virginia Source · since 2026-07-01$33.97——Plans negotiate; applies out of network—
See all 11 states for 99374 — start free

4 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 99374 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 99374?

It depends on the state. Of the 11 states with a published fee-for-service rate, the median is $45.64. New Mexico pays the most ($96.86) and Virginia the least ($33.97).

Which state pays the highest Medicaid rate for 99374?

New Mexico, at $96.86, effective 2025-01-01.

Do managed-care plans pay the same rate for 99374?

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.