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

Medicaid Fee Schedule Lookup

Look up any CPT or HCPCS code across 50 Medicaid programs: 17,674 codes of current, state-published fee-for-service physician rates in one search.

Free for quick checks. The PayerPrice platform adds every state for every code, each program's schedules back to 2001, and commercial payer rates side by side.

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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
99213Office visit, established patient (low complexity)All 50 jurisdictions46$34.40KS$71.05$165.33AK
99214Office visit, established patient (moderate complexity)All 50 jurisdictions46$51.86TX$101.31$236.62AK
99203Office visit, new patient (low complexity)All 50 jurisdictions46$46.60NH$90.52$202.92AK
99204Office visit, new patient (moderate complexity)All 50 jurisdictions46$69.90NH$134.57$309.91AK
99285Emergency department visit, high severity with threat to functionAll 50 jurisdictions46$62.87WI$138.99$323.58AK
99283Emergency department visit, moderate severityUp to 8 jurisdictions468 shown freeIn platformIn platformIn platform
99284Emergency department visit, high severityUp to 8 jurisdictions468 shown freeIn platformIn platformIn platform
93000Electrocardiogram, completeUp to 8 jurisdictions468 shown freeIn platformIn platformIn platform
93306Echocardiography, complete with DopplerUp to 8 jurisdictions468 shown freeIn platformIn platformIn platform
96372Therapeutic injection, subcutaneous or intramuscularUp to 8 jurisdictions448 shown freeIn platformIn platformIn platform
20610Arthrocentesis, major joint or bursaUp to 8 jurisdictions468 shown freeIn platformIn platformIn platform
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
19120Excision of breast lesionUp to 8 jurisdictions468 shown freeIn platformIn platformIn platform
29881Knee arthroscopy with meniscectomyUp to 8 jurisdictions468 shown freeIn platformIn platformIn platform
45378Diagnostic colonoscopyUp to 8 jurisdictions468 shown freeIn platformIn platformIn platform
47562Laparoscopic cholecystectomyUp to 8 jurisdictions468 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 jurisdictions468 shown freeIn platformIn platformIn platform
90834Psychotherapy, 45 minutesUp to 8 jurisdictions398 shown freeIn platformIn platformIn platform
90837Psychotherapy, 60 minutesUp to 8 jurisdictions398 shown freeIn platformIn platformIn platform
Loading every published code...

Figures compare unmodified non-facility rates. California provider rates and modifier tuples remain separate choices, 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.

Rates can differ by rate type within one state. Medi-Cal pays $82.02 for 99213 under Justice Involved but $24.00 under Podiatrist. States can set different rates for the same code by provider type, program or region. Figures above are each state's median across its rate types; every code page lists each one.

See 99213 by rate type
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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 2001, and negotiated rates from more than 180 commercial payers by NPI, TIN, and ZIP code.

  • Price a code list across every state you bill
  • Check a managed-care offer against the state rate
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  • Track rate changes across schedule periods
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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 - September 2026New YorkNY Medicaid - October 2026TexasTexas Medicaid - September 2026FloridaFlorida Medicaid - July 2026PennsylvaniaPennsylvania Medical Assistance - October 2026IllinoisIllinois Medicaid - July 2026North CarolinaNC Medicaid - January 2026OhioOhio Medicaid - January 2026MichiganMichigan Medicaid - September 2026GeorgiaGeorgia Medicaid - July 2026

Jurisdiction coverage and sources

JurisdictionProgramEffectiveCodesRatesPublished source
CaliforniaMedi-CalSeptember 202611,29625,007Medi-Cal Rates Information
New YorkNY MedicaidOctober 20266381,203eMedNY Physician Manual Fee Schedule
TexasTexas MedicaidSeptember 20268,43518,855TMHP Static Fee Schedules
FloridaFlorida MedicaidJuly 20265477AHCA Practitioner Fee Schedule
PennsylvaniaPennsylvania Medical AssistanceOctober 20266,59333,901DHS Outpatient Fee Schedule
IllinoisIllinois MedicaidJuly 20269,31912,946HFS Practitioner Fee Schedule
North CarolinaNC MedicaidJanuary 20268,40210,226NC Medicaid Physician Services Fee Schedules
OhioOhio MedicaidJanuary 20267,3099,030Ohio Medicaid Schedules & Rates
MichiganMichigan MedicaidSeptember 20269,25512,718MDHHS Practitioner Fee Schedule
GeorgiaGeorgia MedicaidJuly 20267,1078,917GAMMIS Fee Schedules
AlabamaAlabama MedicaidSeptember 20265,9286,075Alabama Medicaid Fee Schedules
AlaskaAlaska MedicaidJuly 20266,8328,256Alaska Medicaid Fee Schedules
ArizonaAHCCCSOctober 20267,61046,258AHCCCS Physician Rates
ArkansasArkansas MedicaidSeptember 20269,51119,171DHS Provider Fee Schedules
ColoradoHealth First ColoradoJuly 202610,09812,646HCPF Provider Rates & Fee Schedule
ConnecticutConnecticut Medical Assistance ProgramOctober 20268,31212,792CMAP Provider Fee Schedule Download
DelawareDelaware Medical Assistance ProgramJanuary 202610,05012,228DMAP Practitioner Fee Schedule
District of ColumbiaDC MedicaidApril 20262,2812,535DHCF Professional Fee Schedule
HawaiiMed-QUESTJune 202611,58711,587Med-QUEST Fee Schedules
IdahoIdaho MedicaidOctober 202612,40918,945Idaho Medicaid Fee Schedule
IndianaIndiana Health Coverage ProgramsSeptember 202612,85316,660IHCP Fee Schedules
IowaIowa MedicaidSeptember 202610,13958,498Iowa HHS Fee Schedules
KansasKansas Medical Assistance ProgramOctober 202611,54542,429KMAP Provider Pricing
KentuckyKentucky MedicaidJanuary 20267,51516,571DMS Fees & Rates
LouisianaLouisiana MedicaidJuly 20266,90116,340Louisiana Medicaid Fee Schedules
MaineMaineCareSeptember 2026788788MaineCare Provider Fee Schedules
MarylandMaryland MedicaidSeptember 20268,53310,519MDH Professional Services Fee Schedule
MassachusettsMassHealthOctober 20267,4839,190101 CMR 317.00, Rates for Medicine Services
MinnesotaMinnesota Health Care ProgramsSeptember 202612,60214,489MHCP Fee Schedule
MississippiMississippi MedicaidJuly 20266,2676,792DOM Fee Schedules & Rates
MissouriMO HealthNetOctober 20269,45134,584MO HealthNet Fee Schedules
MontanaMontana MedicaidJanuary 202610,45212,409Montana Medicaid Fee Schedules
NebraskaNebraska MedicaidJuly 20268,47414,992DHHS Provider Rates & Fee Schedules
NevadaNevada MedicaidJuly 20269,24242,771Nevada Medicaid Fee Schedules
New HampshireNew Hampshire MedicaidJuly 202612,53813,422NH MMIS Documents & Forms
New JerseyNJ FamilyCareJuly 202612,79365,611NJMMIS Procedure Master
New MexicoNew Mexico MedicaidMarch 20269,13910,838HCA Fee Schedules
North DakotaNorth Dakota MedicaidAugust 20268,97110,663ND HHS Fee Schedules
OklahomaSoonerCareJuly 20269,71111,596OHCA Fee Schedule
OregonOregon Health PlanSeptember 202612,25328,792OHP Fee Schedule
Rhode IslandRhode Island MedicaidOctober 202612,35458,894EOHHS Fee Schedules
South CarolinaHealthy ConnectionsOctober 20268,62577,186SCDHHS Fee Schedules
South DakotaSouth Dakota MedicaidJuly 20267,7757,775DSS Medicaid Fee Schedules
UtahUtah MedicaidOctober 20269,33822,019Utah Medicaid Fee Schedule Lookup
VermontVermont MedicaidOctober 202611,87514,338Vermont Medicaid Fee Schedule Lookup
VirginiaVirginia MedicaidOctober 20268,74818,778DMAS Procedure Fee Files
WashingtonApple HealthOctober 20268,72710,483HCA Provider Billing Guides & Fee Schedules
West VirginiaWest Virginia MedicaidApril 20267,0028,628BMS Physician RBRVS Fee Schedules
WisconsinForwardHealthAugust 20267,75421,922ForwardHealth Maximum Allowable Fee Schedule
WyomingWyoming MedicaidSeptember 202611,58212,977Wyoming Medicaid Fee Schedules

Largest programs by enrollment first, then by name. 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. No comparable statewide physician fee schedule is available for Tennessee; see why below.

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.

Jurisdictions without a statewide physician 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.

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

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, rate type, 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.