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Rates through September 2026State-published files · No login required

Medicaid Fee Schedule Lookup

Compare current, state-published Medicaid fee-for-service physician rates across 48 jurisdictions by CPT or HCPCS code. Each figure is the median unmodified non-facility amount in a program's latest published schedule.

These are agency-published fee-for-service amounts, not managed-care contracted rates or a guarantee of payment. The free view shows all covered jurisdictions for 99213, 99214, 99203, 99204, 99285 and up to 8 jurisdictions for other published codes.

Current, state-published Medicaid fee-for-service rates; managed-care contracts are not included.Need complete history? Book a demo

Every code with published Medicaid rates

Loading every published code...
DescriptionFree viewLowestMedianHighest
93000Electrocardiogram, completeUp to 8 jurisdictions488 shown freeIn platformIn platformIn platform
93306Echocardiography, complete with DopplerUp to 8 jurisdictions488 shown freeIn platformIn platformIn platform
99203Office visit, new patient (low complexity)All 48 jurisdictions48$46.60NH$84.75$202.92AK
99204Office visit, new patient (moderate complexity)All 48 jurisdictions47$68.90CA$128.18$309.91AK
99213Office visit, established patient (low complexity)All 48 jurisdictions47$24.00CA$68.11$165.33AK
99214Office visit, established patient (moderate complexity)All 48 jurisdictions47$37.50CA$96.15$236.62AK
11042Debridement, subcutaneous tissueUp to 8 jurisdictions468 shown freeIn platformIn platformIn platform
12001Simple wound repair, 2.5 cm or lessUp to 8 jurisdictions468 shown freeIn platformIn platformIn platform
20610Arthrocentesis, major joint or bursaUp to 8 jurisdictions468 shown freeIn platformIn platformIn platform
45378Diagnostic colonoscopyUp to 8 jurisdictions468 shown freeIn platformIn platformIn platform
19120Excision of breast lesionUp to 8 jurisdictions458 shown freeIn platformIn platformIn platform
64483Transforaminal epidural injection, lumbar or sacralUp to 8 jurisdictions458 shown freeIn platformIn platformIn platform
66984Cataract removal with intraocular lensUp to 8 jurisdictions458 shown freeIn platformIn platformIn platform
29881Knee arthroscopy with meniscectomyUp to 8 jurisdictions448 shown freeIn platformIn platformIn platform
96372Therapeutic injection, subcutaneous or intramuscularUp to 8 jurisdictions448 shown freeIn platformIn platformIn platform
99283Emergency department visit, moderate severityUp to 8 jurisdictions448 shown freeIn platformIn platformIn platform
99284Emergency department visit, high severityUp to 8 jurisdictions448 shown freeIn platformIn platformIn platform
99285Emergency department visit, high severity with threat to functionAll 48 jurisdictions44$66.18WI$138.69$323.58AK
47562Laparoscopic cholecystectomyUp to 8 jurisdictions438 shown freeIn platformIn platformIn platform
90834Psychotherapy, 45 minutesUp to 8 jurisdictions408 shown freeIn platformIn platformIn platform
90837Psychotherapy, 60 minutesUp to 8 jurisdictions408 shown freeIn platformIn platformIn platform
Loading every published code...

Figures are the spread across the jurisdictions that price each code, every one contributing its median unmodified non-facility rate, and are shown for the codes published across every covered jurisdiction. Opening any other code returns its real rates for up to 8 jurisdictions; additional rates are labeled as available in the platform rather than represented by synthetic amounts.

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See every jurisdiction, every period, and what commercial payers pay

Every covered jurisdiction that prices a code rather than the handful shown here, each program's schedules back to 2003, and negotiated rates from more than 180 commercial payers by NPI, TIN, and ZIP code.

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Popular Medicaid fee schedules by state

The ten largest state Medicaid and CHIP programs by April 2026 CMS enrollment, with current physician rates and official sources.

CaliforniaMedi-Cal - April 2026New YorkNY Medicaid - July 2026TexasTexas Medicaid - July 2026FloridaFlorida Medicaid - January 2026PennsylvaniaPennsylvania Medical Assistance - August 2026IllinoisIllinois Medicaid - July 2026North CarolinaNC Medicaid - January 2026OhioOhio Medicaid - January 2026MichiganMichigan Medicaid - July 2026GeorgiaGeorgia Medicaid - July 2026

Jurisdiction coverage and sources

JurisdictionProgramEffectiveCodesRatesPublished source
AlaskaAlaska MedicaidJuly 20266,8318,255Alaska Medicaid Fee Schedules
AlabamaAlabama MedicaidApril 20266,2387,816Alabama Medicaid Fee Schedules
ArkansasArkansas MedicaidAugust 20269,48513,407DHS Provider Fee Schedules
ArizonaAHCCCSOctober 20257,53111,921AHCCCS Physician Rates
CaliforniaMedi-CalApril 202611,29416,741Medi-Cal Rates Information
ColoradoHealth First ColoradoApril 20262,6073,623HCPF Provider Rates & Fee Schedule
ConnecticutConnecticut Medical Assistance ProgramJuly 20268,24210,055CMAP Provider Fee Schedule Download
District of ColumbiaDC MedicaidApril 20269,69914,388DHCF Professional Fee Schedule
DelawareDelaware Medical Assistance ProgramJanuary 20269,83111,980DMAP Practitioner Fee Schedule
FloridaFlorida MedicaidJanuary 20266,2826,825AHCA Practitioner Fee Schedule
GeorgiaGeorgia MedicaidJuly 20267,1008,770GAMMIS Fee Schedules
HawaiiMed-QUESTJune 202611,00111,001Med-QUEST Fee Schedules
IowaIowa MedicaidAugust 202610,34812,146Iowa HHS Fee Schedules
IdahoIdaho MedicaidJuly 202512,06713,743Idaho Medicaid Fee Schedule
IllinoisIllinois MedicaidJuly 20269,32812,899HFS Practitioner Fee Schedule
IndianaIndiana Health Coverage ProgramsAugust 202612,71915,419IHCP Fee Schedules
KansasKansas Medical Assistance ProgramAugust 202611,28615,740KMAP Provider Pricing
KentuckyKentucky MedicaidJanuary 20267,6159,305DMS Fees & Rates
LouisianaLouisiana MedicaidJanuary 20266,8886,907Louisiana Medicaid Fee Schedules
MassachusettsMassHealthJanuary 20269631,394101 CMR 317.00, Rates for Medicine Services
MaineMaineCareJanuary 20266,6567,159MaineCare Provider Fee Schedules
MichiganMichigan MedicaidJuly 20269,24612,697MDHHS Practitioner Fee Schedule
MinnesotaMinnesota Health Care ProgramsAugust 202612,60614,493MHCP Fee Schedule
MissouriMO HealthNetJuly 20267,15026,483MO HealthNet Fee Schedules
MississippiMississippi MedicaidJuly 20266,2666,704DOM Fee Schedules & Rates
MontanaMontana MedicaidJanuary 202610,33412,251Montana Medicaid Fee Schedules
North CarolinaNC MedicaidJanuary 20268,39310,216NC Medicaid Physician Services Fee Schedules
North DakotaNorth Dakota MedicaidJuly 20268,95110,640ND HHS Fee Schedules
NebraskaNebraska MedicaidJuly 20268,47314,991DHHS Provider Rates & Fee Schedules
New HampshireNew Hampshire MedicaidJanuary 202612,30112,547NH MMIS Documents & Forms
New JerseyNJ FamilyCareJuly 202612,28715,428NJMMIS Procedure Master
New MexicoNew Mexico MedicaidMarch 20268,88510,584HCA Fee Schedules
NevadaNevada MedicaidJuly 20269,23831,187Nevada Medicaid Fee Schedules
New YorkNY MedicaidJuly 20266,2156,215eMedNY Physician Manual Fee Schedule
OhioOhio MedicaidJanuary 20267,2987,308Ohio Medicaid Schedules & Rates
OklahomaSoonerCareJuly 20269,68511,569OHCA Fee Schedule
OregonOregon Health PlanJuly 202612,28925,525OHP Fee Schedule
PennsylvaniaPennsylvania Medical AssistanceAugust 20264,6526,623DHS Outpatient Fee Schedule
South CarolinaHealthy ConnectionsAugust 20268,61457,167SCDHHS Fee Schedules
South DakotaSouth Dakota MedicaidJuly 20267,6787,678DSS Medicaid Fee Schedules
TexasTexas MedicaidJuly 20266,9848,664TMHP Static Fee Schedules
UtahUtah MedicaidJuly 20269,32922,000Utah Medicaid Fee Schedule Lookup
VirginiaVirginia MedicaidAugust 20268,97512,166DMAS Procedure Fee Files
VermontVermont MedicaidAugust 202612,07813,777Vermont Medicaid Fee Schedule Lookup
WashingtonApple HealthJuly 20268,70710,451HCA Provider Billing Guides & Fee Schedules
WisconsinForwardHealthAugust 20267,6699,160ForwardHealth Maximum Allowable Fee Schedule
West VirginiaWest Virginia MedicaidApril 20266,9998,625BMS Physician RBRVS Fee Schedules
WyomingWyoming MedicaidSeptember 202611,51011,921Wyoming Medicaid Fee Schedules

Coverage expands as additional fee schedules are parsed and published. Each jurisdiction is shown at its most recent published period, which differs because programs update on their own cadence. 2 jurisdictions are not on this list and are not pending - Tennessee and Maryland publish no fee schedule file that can be loaded, for the reasons below.

Jurisdictions with no published fee schedule

TennesseeTennCareNo physician fee schedule published

TennCare has bought capitated managed care since 1994, so what a physician is paid is set in each MCO's provider contracts - BlueCare / TennCare Select (BCBST), UnitedHealthcare Community Plan, Wellpoint - rather than by the state. TennCare does direct some rates under 42 CFR 438.6(c): minimum fee schedules for nursing facilities, HCBS providers and behavioral health crisis services, and maximum fee schedules for DME back braces, physical, occupational and speech therapy, and caesarean section deliveries. Physician evaluation and management is on neither list, and no statewide procedure-level physician schedule is published.

There is no comprehensive Tennessee Medicaid physician fee schedule. A Tennessee figure for an ordinary office visit is one MCO's contracted amount with one provider, and has to be labelled that way.

Sources
  • CMS - Managed Care in Tennessee (2014 profile)Establishes the starting point, in CMS's words: “Tennessee began its Medicaid managed care program, TennCare, in 1994. Its managed care program is statewide and mandatory for all coverage groups.” The profile is a 2014 snapshot, so it is cited for that and not for anything current.
  • TennCare MCO statewide contractSection 3.1.5.1.6 lists every rate TennCare directs: minimum fee schedules for nursing facilities, HCBS providers and behavioral health crisis services; maximum fee schedules for DME back braces, physical, occupational and speech therapy, and caesarean section deliveries. Physician evaluation and management appears on neither list.
  • TennCare CHOICES cost-neutrality capsWhat TennCare does price directly, it publishes like this: a nursing facility per diem of $294.87 and private duty nursing at $53.27 an hour, alongside per-member cost caps. Real state-set prices, and nothing at the CPT grain.
MarylandMaryland MedicaidNo downloadable fee schedule

Maryland sets fee-for-service rates, but stopped publishing them as files. General Provider Transmittal No. 121, effective May 2026, moved the professional services fee schedules to a read-only online embed with no export, and no downloadable schedule remains on the state's document host.

Sources

Every other jurisdiction outside the table above is one we have not loaded yet, not one that publishes nothing.

Commercial rates for the same codes

99213Office visit, established patient (low complexity)99214Office visit, established patient (moderate complexity)99203Office visit, new patient (low complexity)99204Office visit, new patient (moderate complexity)99283Emergency department visit, moderate severity99284Emergency department visit, high severity99285Emergency department visit, high severity with threat to function93000Electrocardiogram, complete93306Echocardiography, complete with Doppler96372Therapeutic injection, subcutaneous or intramuscular20610Arthrocentesis, major joint or bursa11042Debridement, subcutaneous tissue12001Simple wound repair, 2.5 cm or less19120Excision of breast lesion29881Knee arthroscopy with meniscectomy45378Diagnostic colonoscopy47562Laparoscopic cholecystectomy64483Transforaminal epidural injection, lumbar or sacral66984Cataract removal with intraocular lens90834Psychotherapy, 45 minutes90837Psychotherapy, 60 minutes

These Medicaid fee-for-service amounts and commercial negotiated rates answer different pricing questions. Each link opens what commercial payers have published for the same code for side-by-side context.

Methodology

Each jurisdiction's published Medicaid fee-for-service physician schedule is downloaded at the source, parsed, and normalized into a shared schema of jurisdiction, effective period, section, code, modifier, non-facility rate, and facility rate. Rates are carried through unchanged - no averaging, interpolation, or cross-jurisdiction adjustment is applied. Where a program publishes a single rate for both settings, the same value appears in both columns. Managed-care contracts, eligibility, coverage rules, modifiers not shown, and claim-specific adjustments can produce different payment.

Medicaid benefits and coverage at Medicaid.gov
Looking for Medicare rates? Search the Medicare fee schedule.