G2077 Medicaid reimbursement rate by state (2026)
Periodic assessment; assessing periodically by an otp.... Medicaid pays a median of $113.44 for G2077 across 10 states, from $22.00 in Alabama to $147.93 in North Dakota.
- States publishing
- 10
- National median
- $113.44units vary by state
- Lowest
- $22.00Alabama
- Highest
- $147.93North Dakota
What does Medicaid pay for G2077?
10 state Medicaid programs publish a fee-for-service rate for G2077. The national median is $113.44 (units differ between states). North Dakota pays the most, $147.93, and Alabama the least, $22.00, a 6.7x spread.
G2077 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.
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 G2077, 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 10 states list more than one rate for G2077, 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 G2077 per unit, and 9 schedules print no unit at all (a flat amount per service).
- Per hour. G2077 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 G2077, 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.
Why G2077 rates differ between states
Published rates for G2077 run from $22.00 in Alabama to $147.93 in North Dakota, a 6.7x gap in the same unit. Half the states pay more than the median of $113.44 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.
- 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.
- 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.
Timing matters too. 6 states set the current rate for G2077 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.
What managed-care plans pay for G2077
No managed-care plan publishes what it pays for G2077. 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 4 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 3 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 must pay at least the published rate (4 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.
- Plans negotiate; the published rate applies out of network (3 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.
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 North Dakota managed care.
Units and billing for G2077
G2077 is a HCPCS Level II professional services code in the physician & professional line, billed mostly by physicians, nurse practitioners, physician assistants and other licensed practitioners. G codes describe professional services and procedures that have no CPT code, or that payers define more narrowly. Many are timed, so check the unit before comparing.
Where a state publishes separate facility and non-facility amounts, the non-facility (office) amount is usually higher because the practice carries the overhead. 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.
Frequently asked questions
What does Medicaid pay for G2077?
It depends on the state. Of the 10 states with a published fee-for-service rate, the median is $113.44. North Dakota pays the most ($147.93) and Alabama the least ($22.00).
Which state pays the highest Medicaid rate for G2077?
North Dakota, at $147.93, effective 2026-02-08.
Which state pays the lowest Medicaid rate for G2077?
Alabama, at $22.00, effective 2026-04-10.
What unit is G2077 billed in?
Of the 10 states, 1 publish G2077 per unit, and 9 schedules print no unit at all (a flat amount per service).
Do managed-care plans pay the same rate for G2077?
Not necessarily. In 4 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 3 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.