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

Medicaid Fee Schedule Lookup

47 state Medicaid agencies each publish their physician fee schedule in their own format, on their own cadence. This lookup parses those files into one schema so a CPT or HCPCS code can be compared across states: one figure per state, the median of the unmodified non-facility rates it publishes. Section, modifier and facility detail sits behind it in the platform.

Free here: current rates for 99213, 99214, 99203, 99204, 99285 across all 47 states, and a few states each for almost every other code in the 16,344. The remaining states, and every schedule published since 2003, are in the platform.

Available data
47
States covered
16,344
Distinct codes
604,643
Published rates
5
Codes free in all 47 states

Every code with published Medicaid rates

Loading every published code...
DescriptionFree viewLowestMedianHighest
Electrocardiogram, completeUp to 8 states478 shown free
Echocardiography, complete with DopplerUp to 8 states478 shown free
Office visit, new patient (low complexity)All 47 states47$46.60NH$84.70$202.92AK
Office visit, new patient (moderate complexity)All 47 states46$68.90CA$128.06$309.91AK
Office visit, established patient (low complexity)All 47 states46$24.00CA$66.69$165.33AK
Office visit, established patient (moderate complexity)All 47 states46$37.50CA$95.92$236.62AK
Debridement, subcutaneous tissueUp to 8 states458 shown free
Simple wound repair, 2.5 cm or lessUp to 8 states458 shown free
Arthrocentesis, major joint or bursaUp to 8 states458 shown free
Diagnostic colonoscopyUp to 8 states458 shown free
Excision of breast lesionUp to 8 states448 shown free
Transforaminal epidural injection, lumbar or sacralUp to 8 states448 shown free
Cataract removal with intraocular lensUp to 8 states448 shown free
Knee arthroscopy with meniscectomyUp to 8 states438 shown free
Therapeutic injection, subcutaneous or intramuscularUp to 8 states438 shown free
Emergency department visit, moderate severityUp to 8 states438 shown free
Emergency department visit, high severityUp to 8 states438 shown free
Emergency department visit, high severity with threat to functionAll 47 states43$66.18WI$138.64$323.58AK
Laparoscopic cholecystectomyUp to 8 states428 shown free
Psychotherapy, 45 minutesUp to 8 states398 shown free
Psychotherapy, 60 minutesUp to 8 states398 shown free
Loading every published code...

Figures are the spread across the states that price each code, every one contributing its median unmodified non-facility rate, and are shown for the codes published across every state. Opening any other code returns its real rates for up to 8 states, which is why its all-state spread stays blurred here. Blurred figures are placeholders, not rates.

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

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

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State coverage and sources

StateProgramEffectiveCodesRatesPublished 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

Coverage expands as additional state fee schedules are parsed and published. Each state is shown at its most recent published period, which differs by state because agencies update on their own cadence.

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

Medicaid sets the floor. Each link opens what commercial payers have published for the same CPT code, so the two can be read side by side.

Methodology

Each state's published physician fee schedule is downloaded at the source, parsed, and normalized into a shared schema of state, effective period, section, code, modifier, non-facility rate, and facility rate. Rates are carried through unchanged - no averaging, interpolation, or cross-state adjustment is applied. Where a state publishes a single rate for both settings, the same value appears in both columns.

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