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Billing code G9008 · Physician & professional

G9008 Medicaid reimbursement rate by state (2026)

Coordinated care fee. Medicaid pays a median of $23.35 for G9008 across 6 states, from $2.85 in Alabama to $396.83 in Delaware.

Data as of Oct 5, 20266 statesEvery rate links to its official source

States publishing
6
National median
$23.35units vary by state
Lowest
$2.85Alabama
Highest
$396.83Delaware
Answer

What does Medicaid pay for G9008?

6 state Medicaid programs publish a fee-for-service rate for G9008. The national median is $23.35 (units differ between states). Delaware pays the most, $396.83, and Alabama the least, $2.85, a 139.2x spread.

State ranking

G9008 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 6 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Delaware Source · since 2026-01-01$396.83——Paid by the state, outside plans—
2South Carolina Source · since 2011-04-08$60.83——Plans negotiate; applies out of network—
3West Virginia Source · since 2023-04-01$38.7015 min$154.80Plans must pay at least this—
6Alabama Source · since 2026-04-01$2.85——Not classified—
See all 6 states for G9008 — start free

2 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.

  • Source for every rate
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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 G9008 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 G9008, 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. 2 of the 6 states list more than one rate for G9008, 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 6 states, 1 publish G9008 per 15 min, and 5 schedules print no unit at all (a flat amount per service).
  • Per hour. Time-based units are converted to an hour of service (four 15-minute units make an hour). 1 of the 6 states bill G9008 by time.
  • 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 G9008, 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 G9008 rates differ between states

Published rates for G9008 run from $2.85 in Alabama to $396.83 in Delaware, a 139.2x gap in the same unit. Half the states pay more than the median of $23.35 and half pay less. The usual reasons for a spread like this in physician & professional rates:

  • 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.
  • 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.

Timing matters too. 3 states set the current rate for G9008 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 G9008

No managed-care plan publishes what it pays for G9008. 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 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 2 states, plans negotiate and the published rate is a benchmark or out-of-network default. In 1 state, the service is paid outside the plans or through a state-directed payment. The rule for the remaining 2 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (2 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.
  • Paid by the state, outside the plans (1 state). Bill the state's Medicaid program, not the plan, at the published rate. There is no plan contract to negotiate for this service.
  • Plans must pay at least the published rate (1 state). 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 Delaware managed care.

Billing

Units and billing for G9008

G9008 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.

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. Physician-fee-schedule codes are billed per service: one unit is one occurrence unless the code itself is defined by time or quantity.

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 G9008?

It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $23.35. Delaware pays the most ($396.83) and Alabama the least ($2.85).

Which state pays the highest Medicaid rate for G9008?

Delaware, at $396.83, effective 2026-01-01.

Which state pays the lowest Medicaid rate for G9008?

Alabama, at $2.85, effective 2026-04-01.

What unit is G9008 billed in?

Of the 6 states, 1 publish G9008 per 15 min, and 5 schedules print no unit at all (a flat amount per service). 1 of the 6 states bill it by time, and their rates are also shown per hour.

Do managed-care plans pay the same rate for G9008?

Not necessarily. In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 2 states, plans negotiate and the published rate is a benchmark or out-of-network default. In 1 state, the service is paid outside the plans or through a state-directed payment. The rule for the remaining 2 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.