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Billing code 99486 · Physician & professional

99486 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $52.20 for 99486 across 15 states, from $38.94 in Maine to $117.76 in Alaska.

Data as of Oct 5, 202615 statesEvery rate links to its official source

States publishing
15
National median
$52.20units vary by state
Lowest
$38.94Maine
Highest
$117.76Alaska
Answer

What does Medicaid pay for 99486?

15 state Medicaid programs publish a fee-for-service rate for 99486. The national median is $52.20 (units differ between states). Alaska pays the most, $117.76, and Maine the least, $38.94, a 3.0x spread.

State ranking

99486 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 15 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Alaska Source · since 2026-07-01$117.76——Not classified—
2Alabama Source · since 2026-09-24$82.36——Not classified—
3Maryland Source · since 2026-01-01$65.55——Plans must pay at least this—
7Kentucky Source · since 2020-01-01$52.68——Plans negotiate; applies out of network—
8Arizona Source · since 2026-10-01$52.20——Plans negotiate; applies out of network—
9Colorado Source · since 2026-07-01$51.34——Plans negotiate; applies out of network—
14Rhode Island Source · since 2013-01-01$39.22——Plans negotiate; applies out of network—
15Maine Source · since 2026-01-01$38.94——Not classified—
See all 15 states for 99486 — start free

7 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 99486 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 99486?

It depends on the state. Of the 15 states with a published fee-for-service rate, the median is $52.20. Alaska pays the most ($117.76) and Maine the least ($38.94).

Which state pays the highest Medicaid rate for 99486?

Alaska, at $117.76, effective 2026-07-01.

Do managed-care plans pay the same rate for 99486?

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.