Professional / technical component share of a procedure fee: Medicaid rates by state

States publish professional / technical component share of a procedure fee under their own codes, modifiers and units. To compare them, this page picks the rate in each state that matches the same service and provider level.

• Provider level. States are compared at the same provider level wherever the schedule distinguishes one. Rates for other levels on file (any qualified provider) are kept separate, never mixed into this ranking.
• Unit. All 1 states publish their headline rate per percent, so the amounts compare directly. The ranking uses the rate as published, so read the unit before comparing two states.
• Variants. 1 of the 1 states publish more than one rate for this service (by modifier, program, setting or provider type); the headline rate is the one that matches the comparison, and the workspace lists every variant.
• Depth. 1,656 rates for this service are on file across all states, versions and provider levels; this page shows one headline rate per state.

The highest-paying state, New Hampshire, pays $50.00; the lowest, New Hampshire, pays $50.00. 1 of the 1 states pay above the median of —. Common reasons rates for physician & professional services spread this way:

• 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.
• 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.
• 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.

Billing notes

Where a state publishes separate facility and non-facility amounts, the non-facility (office) amount is usually higher because the practice carries the overhead. Physician-fee-schedule codes are billed per service: one unit is one occurrence unless the code itself is defined by time or quantity.