New York doctors who treat Medicaid patients are paid “far less” than doctors in other states, according to a new report.

The state’s doctors earn $20 for an hour-long consultation with an established patient, while doctors in higher-paying states earn, on average, $49.20 for a 15-minute visit or $157.92 for an hour-long appointment, according to a report published yesterday by the Washington, D.C.-based group Public Citizen.

Other low-paying states include New Jersey, Rhode Island, and Pennsylvania, according to the group, which was founded by Ralph Nader. The report is based on an analysis of 10 states identified in a 2003 study as having the highest and lowest Medicaid reimbursement rates. States with the highest reimbursement rates include Alaska, Wyoming, Delaware, Arizona, North Carolina, and Arkansas.

The fee differences mean Medicaid patients may receive “lower-tier care” in states with lower payments to doctors, the director of the Health Research Group at Public Citizen, Dr. Sidney Wolfe, said in a statement. “As long as Medicaid fee schedules shortchange providers, the program and its clientele will be considered less worthy, and access to care will be restricted,” she said.

The report also found a disparity between Medicaid and Medicare payments to doctors in New York. A doctor who earns $20 from Medicaid may earn $196.47 for Medicare, according to the report.

The president of the Medical Society of the State of New York, Dr. Robert Goldberg, said yesterday: “We’ve been complaining about it for a very long time.” He said specialists are reimbursed even less under Medicaid, earning less than $10 for each patient visit.