NP Reimbursement 2026
What commercial insurers list for nurse practitioner visits in 25 states, how that compares with Medicare and Medicaid, and what insurers list for platform billing groups. Every figure links to its state page and can be checked.
The Medicare and Medicaid check, state by state
Solo NP practice, moderate follow-up visit (99214). Typical = the middle of each insurer’s typical rate, one vote per insurer.
| State | Solo NP typical | Insurers | Medicare 2026 NP | % of Medicare | Medicaid NP |
|---|---|---|---|---|---|
| Alabama | $90.27 | 6 | $106.45 | 85% | Not published |
| Arizona | $102.02 | 6 | $112.93 | 90% | Not published |
| California | $98.48 | 6 | $119.80–$144.52 | 75% | $115.88 |
| Colorado | $109.17 | 5 | $118.69 | 92% | Not published |
| Connecticut | $100.55 | 5 | $121.57 | 83% | Not published |
| Florida | $108.02 | 9 | $114.77–$123.67 | 91% | $42.74 |
| Georgia | $107.84 | 7 | $109.90–$117.14 | 95% | $104.14 |
| Illinois | $114.62 | 7 | $112.57–$121.08 | 98% | Not published |
| Indiana | $95.82 | 6 | $109.08 | 88% | $100.42 |
| Kentucky | $90.85 | 6 | $108.63 | 84% | Not published |
| Maryland | $100.07 | 4 | $116.17–$121.23 | 84% | Not published |
| Massachusetts | $121.38 | 4 | $118.34–$128.08 | 99% | Not published |
| Michigan | $103.45 | 6 | $110.84–$116.01 | 91% | Not published |
| Minnesota | $91.11 | 4 | $114.11 | 80% | Not published |
| Missouri | $97.93 | 7 | $107.33–$112.55 | 89% | Not published |
| New Jersey | $114.62 | 7 | $123.05–$128.05 | 91% | $89.64 |
| New York | $97.53 | 6 | $111.25–$132.89 | 80% | $115.86 |
| North Carolina | $99.95 | 6 | $110.02 | 91% | $81.76 |
| Ohio | $83.65 | 8 | $110.36 | 76% | $70.11 |
| Pennsylvania | $109.17 | 9 | $110.39–$119.34 | 95% | $54.42 |
| Tennessee | $97.85 | 7 | $108.26 | 90% | Not published |
| Texas | $95.03 | 8 | $109.87–$118.22 | 83% | $43.87 |
| Virginia | $93.36 | 6 | $113.13 | 83% | Not published |
| Washington | $110.00 | 5 | $118.03–$130.15 | 89% | Not published |
| Wisconsin | $105.66 | 5 | $110.13 | 96% | Not published |
What insurers list for platform billing groups
99214, platforms A–Z. "Cells" = insurer-state pairs where both the platform's listed rate and a solo-NP median (5+ groups) exist. The difference is the median of each cell's platform rate vs the solo-NP median. A listed rate is what the insurer lists for the platform's billing group; it is not what the NP is paid, and the gap is not all kept by the platform.
| Platform | Cells | States | Median listed | vs solo NP |
|---|---|---|---|---|
| Alma | 14 | 7 | $136.57 | +19% |
| Brightside | 4 | 3 | $123.81 | +9% |
| Cerebral | 19 | 7 | $99.35 | +3% |
| Charlie Health | 13 | 9 | $97.21 | -3% |
| Cloud Health | 8 | 5 | $104.36 | +6% |
| Done | 6 | 4 | $106.66 | -2% |
| Grow Therapy | 14 | 6 | $125.41 | +12% |
| Headway | 41 | 13 | $134.30 | +17% |
| NOCD | 5 | 5 | $93.84 | +0% |
| Ophelia | 4 | 1 | $109.20 | +5% |
| Rula | 16 | 6 | $117.91 | +5% |
| SonderMind | 12 | 5 | $112.64 | +9% |
| Talkiatry | 10 | 3 | $141.36 | +18% |
| Talkspace | 4 | 3 | $137.89 | +19% |
| Tava Health | 9 | 7 | $106.00 | +4% |
| Teladoc | 4 | 3 | $98.44 | -5% |
| Two Chairs | 3 | 2 | $111.90 | +3% |
| Valera Health | 6 | 3 | $102.08 | +0% |
See also: Headway vs Grow vs Rula, compared · every platform by state.
NP-owned vs physician-led billing
Who owns the billing group matters differently by insurer. For 99214, NP-owned groups list lower than physician-led groups in 53 insurer-state pairs and higher in 17. That is why NP Link does not claim that joining a physician group raises your rate; each state page shows the split insurer by insurer.
Coverage gaps
States not listed on the state index are not yet published. Request one.
Some national insurers are not loaded yet, and a few insurers' files don't separate NP billing groups well enough to publish. A state goes live only with at least 2 in-state insurers that each have a 99214 median from 5+ NP groups.
Method
- Source. Insurer Transparency in Coverage machine-readable files (2026 Q4), CMS 2026 Medicare Physician Fee Schedule (NP rate = 85% of the physician amount), state Medicaid fee schedules.
- One value per billing group. A group with many identical rows counts once, so large groups and duplicated files don't dominate.
- Ghost rates. Files list rates for services a group may never bill. Using one value per group and medians limits their effect; we drop rates under $1 and never publish a cell under 5 groups (middle half: 10+).
- Listed, not paid. A listed rate is the contract amount before copays, deductibles and denials.
Cite as: NP Link, "NP Reimbursement 2026", October 18, 2026. About the data.
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