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.
Free: state-by-state rates for 99213, 99214, 99203, 99204, 99285 at each state's current schedule. Any other code returns real rates for a few states rather than all of them; the remaining states, and every schedule published since 2003, are part of the platform.
Common codes - non-facility rate across 47 states
| Code | Description | States | Lowest | Median | Highest |
|---|---|---|---|---|---|
| Every state - all 47click through for the full map, state by state | |||||
| Office visit, established patient (low complexity) | 46 | $24.00CA | $66.69 | $165.33AK | |
| Office visit, established patient (moderate complexity) | 46 | $37.50CA | $95.92 | $236.62AK | |
| Office visit, new patient (low complexity) | 47 | $46.60NH | $84.70 | $202.92AK | |
| Office visit, new patient (moderate complexity) | 46 | $68.90CA | $128.06 | $309.91AK | |
| Emergency department visit, high severity with threat to function | 43 | $66.18WI | $138.64 | $323.58AK | |
| Up to 8 states freeopen one for its real rates across the preview states | |||||
| Emergency department visit, moderate severity | 43 | ||||
| Emergency department visit, high severity | 43 | ||||
| Electrocardiogram, complete | 47 | ||||
| Echocardiography, complete with Doppler | 47 | ||||
| Therapeutic injection, subcutaneous or intramuscular | 43 | ||||
| Arthrocentesis, major joint or bursa | 45 | ||||
| Debridement, subcutaneous tissue | 45 | ||||
| Simple wound repair, 2.5 cm or less | 45 | ||||
| Excision of breast lesion | 44 | ||||
| Knee arthroscopy with meniscectomy | 43 | ||||
| Diagnostic colonoscopy | 45 | ||||
| Laparoscopic cholecystectomy | 42 | ||||
| Transforaminal epidural injection, lumbar or sacral | 44 | ||||
| Cataract removal with intraocular lens | 44 | ||||
| Psychotherapy, 45 minutes | 39 | ||||
| Psychotherapy, 60 minutes | 39 | ||||
Figures shown are the spread across the states that price each code, every one contributing its median unmodified non-facility rate. Every code here opens except the last group - the preview codes return real rates for up to 8 states rather than all of them, which is why their all-state spread stays blurred here. Blurred figures are placeholders, not rates.
See what commercial payers pay for the same code
Medicaid is the floor. Compare it against negotiated rates from more than 180 commercial payers by NPI, TIN, and ZIP code, and export through API, SQL, MCP, or bulk download.
State coverage and sources
| State | Program | Effective | Codes | Rates | Published source |
|---|---|---|---|---|---|
| Alaska | Alaska Medicaid | July 2026 | 6,831 | 8,255 | Alaska Medicaid Fee Schedules |
| Alabama | Alabama Medicaid | April 2026 | 6,238 | 7,816 | Alabama Medicaid Fee Schedules |
| Arkansas | Arkansas Medicaid | August 2026 | 9,485 | 13,407 | DHS Provider Fee Schedules |
| Arizona | AHCCCS | October 2025 | 7,531 | 11,921 | AHCCCS Physician Rates |
| California | Medi-Cal | April 2026 | 11,294 | 16,741 | Medi-Cal Rates Information |
| Colorado | Health First Colorado | April 2026 | 2,607 | 3,623 | HCPF Provider Rates & Fee Schedule |
| Connecticut | Connecticut Medical Assistance Program | July 2026 | 8,242 | 10,055 | CMAP Provider Fee Schedule Download |
| District of Columbia | DC Medicaid | April 2026 | 9,699 | 14,388 | DHCF Professional Fee Schedule |
| Delaware | Delaware Medical Assistance Program | January 2026 | 9,831 | 11,980 | DMAP Practitioner Fee Schedule |
| Florida | Florida Medicaid | January 2026 | 6,282 | 6,825 | AHCA Practitioner Fee Schedule |
| Georgia | Georgia Medicaid | July 2026 | 7,100 | 8,770 | GAMMIS Fee Schedules |
| Hawaii | Med-QUEST | June 2026 | 11,001 | 11,001 | Med-QUEST Fee Schedules |
| Iowa | Iowa Medicaid | August 2026 | 10,348 | 12,146 | Iowa HHS Fee Schedules |
| Idaho | Idaho Medicaid | July 2025 | 12,067 | 13,743 | Idaho Medicaid Fee Schedule |
| Illinois | Illinois Medicaid | July 2026 | 9,328 | 12,899 | HFS Practitioner Fee Schedule |
| Indiana | Indiana Health Coverage Programs | August 2026 | 12,719 | 15,419 | IHCP Fee Schedules |
| Kansas | Kansas Medical Assistance Program | August 2026 | 11,286 | 15,740 | KMAP Provider Pricing |
| Kentucky | Kentucky Medicaid | January 2026 | 7,615 | 9,305 | DMS Fees & Rates |
| Louisiana | Louisiana Medicaid | January 2026 | 6,888 | 6,907 | Louisiana Medicaid Fee Schedules |
| Massachusetts | MassHealth | January 2026 | 963 | 1,394 | 101 CMR 317.00, Rates for Medicine Services |
| Maine | MaineCare | January 2026 | 6,656 | 7,159 | MaineCare Provider Fee Schedules |
| Michigan | Michigan Medicaid | July 2026 | 9,246 | 12,697 | MDHHS Practitioner Fee Schedule |
| Minnesota | Minnesota Health Care Programs | August 2026 | 12,606 | 14,493 | MHCP Fee Schedule |
| Missouri | MO HealthNet | July 2026 | 7,150 | 26,483 | MO HealthNet Fee Schedules |
| Mississippi | Mississippi Medicaid | July 2026 | 6,266 | 6,704 | DOM Fee Schedules & Rates |
| Montana | Montana Medicaid | January 2026 | 10,334 | 12,251 | Montana Medicaid Fee Schedules |
| North Carolina | NC Medicaid | January 2026 | 8,393 | 10,216 | NC Medicaid Physician Services Fee Schedules |
| North Dakota | North Dakota Medicaid | July 2026 | 8,951 | 10,640 | ND HHS Fee Schedules |
| Nebraska | Nebraska Medicaid | July 2026 | 8,473 | 14,991 | DHHS Provider Rates & Fee Schedules |
| New Hampshire | New Hampshire Medicaid | January 2026 | 12,301 | 12,547 | NH MMIS Documents & Forms |
| New Jersey | NJ FamilyCare | July 2026 | 12,287 | 15,428 | NJMMIS Procedure Master |
| New Mexico | New Mexico Medicaid | March 2026 | 8,885 | 10,584 | HCA Fee Schedules |
| Nevada | Nevada Medicaid | July 2026 | 9,238 | 31,187 | Nevada Medicaid Fee Schedules |
| New York | NY Medicaid | July 2026 | 6,215 | 6,215 | eMedNY Physician Manual Fee Schedule |
| Ohio | Ohio Medicaid | January 2026 | 7,298 | 7,308 | Ohio Medicaid Schedules & Rates |
| Oklahoma | SoonerCare | July 2026 | 9,685 | 11,569 | OHCA Fee Schedule |
| Oregon | Oregon Health Plan | July 2026 | 12,289 | 25,525 | OHP Fee Schedule |
| Pennsylvania | Pennsylvania Medical Assistance | August 2026 | 4,652 | 6,623 | DHS Outpatient Fee Schedule |
| South Carolina | Healthy Connections | August 2026 | 8,614 | 57,167 | SCDHHS Fee Schedules |
| South Dakota | South Dakota Medicaid | July 2026 | 7,678 | 7,678 | DSS Medicaid Fee Schedules |
| Texas | Texas Medicaid | July 2026 | 6,984 | 8,664 | TMHP Static Fee Schedules |
| Utah | Utah Medicaid | July 2026 | 9,329 | 22,000 | Utah Medicaid Fee Schedule Lookup |
| Virginia | Virginia Medicaid | August 2026 | 8,975 | 12,166 | DMAS Procedure Fee Files |
| Vermont | Vermont Medicaid | August 2026 | 12,078 | 13,777 | Vermont Medicaid Fee Schedule Lookup |
| Washington | Apple Health | July 2026 | 8,707 | 10,451 | HCA Provider Billing Guides & Fee Schedules |
| Wisconsin | ForwardHealth | August 2026 | 7,669 | 9,160 | ForwardHealth Maximum Allowable Fee Schedule |
| West Virginia | West Virginia Medicaid | April 2026 | 6,999 | 8,625 | BMS 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
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.govFrequently asked
What does Medicaid pay for 99214?
Across the 46 state fee schedules that price it, the median Medicaid non-facility rate for 99214 — office visit, established patient (moderate complexity) — is $95.92, running from $37.50 in California to $236.62 in Alaska, a 6.3× spread.
How much do Medicaid rates vary between states?
A great deal, and not by a fixed factor. Across the 46 state fee schedules that price it, the median Medicaid non-facility rate for 99213 — office visit, established patient (low complexity) — is $66.69, running from $24.00 in California to $165.33 in Alaska, a 6.9× spread. Each state sets its own fee schedule, so which states sit at the top and bottom changes from code to code.
How do Medicaid rates compare with Medicare rates?
State Medicaid physician fees are set by each state rather than by CMS, and for common office and emergency department visits they typically sit below the Medicare rate for the same code. The size of that gap differs by state and by code, so both are worth checking. This lookup publishes the Medicaid side; the PayerPrice Medicare Fee Schedule Lookup publishes CMS rates for the same CPT and HCPCS codes.
Which Medicaid rates are free to look up here?
Per-state rates for 99213, 99214, 99203, 99204, 99285 at each state's current published schedule, across all 47 states, with no login. Almost every other code in the 16,344 returns real rates too, for a few states each rather than all of them. The remaining states, 604,643 published rates in total, and 105 schedule periods going back to 2003, are in the PayerPrice platform. Figures shown blurred on this page are placeholders, not withheld rates.
How current are these Medicaid fee schedules?
Each state is shown at the most recent schedule it has published, which is not the same month everywhere because agencies update on their own cadence. The newest period across all 47 states is August 2026. The state coverage table lists each state's effective period next to a link to the file the rates came from.
Where do these Medicaid rates come from?
Every rate is taken from the physician fee schedule that the state Medicaid agency itself publishes — the same workbooks and PDFs linked in the state coverage table below. Nothing is modeled or estimated; the files are parsed, normalized into a shared schema, and republished here.
Why does one code have several rates in the same state?
States structure their fee schedules differently. A state may price a code separately by section of the schedule (California), by modifier such as TH or FP (Texas and Florida), or at different amounts for facility and non-facility settings. So that states can be compared side by side, the free view shows one figure per state — the median of its unmodified non-facility rates — and leaves out modifier-specific and facility rows. A state that prices a code only under a modifier therefore shows as not published here, even though the rate exists. Every published combination is available in the platform.
Why is a code missing for a state?
A state fee schedule only lists the codes that state reimburses on a fee-for-service basis. Codes paid through managed care, bundled into another service, or not covered at all do not appear in the published file, so they do not appear here.
Are these the rates a provider is actually paid?
They are the fee-for-service maximums the state publishes. Actual payment can differ for managed care enrollees, for providers with supplemental payment arrangements, and where claim-level edits or copays apply.