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

81404 Medicaid Fee Schedule Rates by State

Compare 81404 across covered Medicaid fee-for-service physician schedules. Comparable rankings use unmodified non-facility rates; provider, program, and modifier-specific fees appear as labeled ranges or separate choices.

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 20 common codes, including 99213, 99214, 99203 and up to 8 jurisdictions for other published codes.

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Current, state-published Medicaid fee-for-service rates; managed-care contracts are not included.See complete Medicaid history for 81404

81404 8 jurisdictions shown, more may be in the platform

Mopath Procedure Level 5, Molecular Pathology Procedure Level 5 (Eg Analysis Of 2-5 Exons By Dna Sequence Analysis Mutation Scanning Or Duplication Deletion Variants Of 6-10 Exons Or Characterization Of A Dynamic Mutation Disorder Triplet Repeat By Southern Blot Analysis) Acads (Acyl-Coa Dehydrogenase C-2 To C-3 Short Chain) (Eg Short Chain Acyl-Coa Dehydrogenase Deficiency) Targeted Sequence Analysis (Eg Exons 5 And 6) Aqp2 (Aquaporin 2 [Collecting Duct]) (Eg Nephrogenic Diabetes Insipidus) Full Gene Sequence Arx (Aristaless Related Homeobox) (Eg X-Linked Lissencephaly With Ambiguous Genitalia X-Linked Intellectual Disability) Full Gene Sequence Avpr2 (Arginine Vasopressin Receptor 2) (Eg Nephrogenic Diabetes Insipidus) Full Gene Sequence Bbs10 (Bardet-Biedl Syndrome 10) (Eg Bardet-Biedl Syndrome) Full Gene Sequence Btd (Biotinidase) (Eg Biotinidase Deficiency) Full Gene Sequence C10orf2 (Chromosome 10 Open Reading Frame 2) (Eg Mitochondrial Dna Depletion Syndrome) Full Gene Sequence Cav3 (Caveolin 3) (Eg Cav3-Related Distal Myopathy Limb-Girdle Muscular Dystrophy Type 1c) Full Gene Sequence Cd40lg (Cd40 Ligand) (Eg X-Linked Hyper Igm Syndrome) Full Gene Sequence Cdkn2a (Cyclin-Dependent Kinase Inhibitor 2a) (Eg Cdkn2a-Related Cutaneous Malignant Melanoma Familial Atypical Mole-Malignant Melanoma Syndrome) Full Gene Sequence Clrn1 (Clarin 1) (Eg Usher Syndrome Type 3) Full Gene Sequence Cox6b1 (Cytochrome C Oxidase Subunit Vib Polypeptide 1) (Eg Mitochondrial Respiratory Chain Complex Iv Deficiency) Full Gene Sequence Cpt2 (Carnitine Palmitoyltransferase 2) (Eg Carnitine Palmitoyltransferase Ii Deficiency) Full Gene Sequence Crx (Cone-Rod Homeobox) (Eg Cone-Rod Dystrophy 2 Leber Congenital Amaurosis) Full Gene Sequence Cyp1b1 (Cytochrome P450 Family 1 Subfamily B Polypeptide 1) (Eg Primary Congenital Glaucoma) Full Gene Sequence Egr2 (Early Growth Response 2) (Eg Charcot-Marie-Tooth) Full Gene Sequence Emd (Emerin) (Eg Emery-Dreifuss Muscular Dystrophy) Duplication Deletion Analysis Epm2a (Epilepsy Progressive Myoclonus Type 2a Lafora Disease [Laforin]) (Eg Progressive Myoclonus Epilepsy) Full Gene Sequence Fgf23 (Fibroblast Growth Factor 23) (Eg Hypophosphatemic Rickets) Full Gene Sequence Fgfr2 (Fibroblast Growth Factor Receptor 2) (Eg Craniosynostosis Apert Syndrome Crouzon Syndrome) Targeted Sequence Analysis (Eg Exons 8 10) Fgfr3 (Fibroblast Growth Factor Receptor 3) (Eg Achondroplasia Hypochondroplasia) Targeted Sequence Analysis (Eg Exons 8 11 12 13) Fhl1 (Four And A Half Lim Domains 1) (Eg Emery-Dreifuss Muscular Dystrophy) Full Gene Sequence Fkrp (Fukutin Related Protein) (Eg Congenital Muscular Dystrophy Type 1c [Mdc1c] Limb-Girdle Muscular Dystrophy [Lgmd] Type 2i) Full Gene Sequence Foxg1 (Forkhead Box G1) (Eg Rett Syndrome) Full Gene Sequence Fshmd1a (Facioscapulohumeral Muscular Dystrophy 1a) (Eg Facioscapulohumeral Muscular Dystrophy) Evaluation To Detect Abnormal (Eg Deleted) Alleles Fshmd1a (Facioscapulohumeral Muscular Dystrophy 1a) (Eg Facioscapulohumeral Muscular Dystrophy) Characterization Of Haplotype(S) (Ie Chromosome 4a And 4b Haplotypes) Gh1 (Growth Hormone 1) (Eg Growth Hormone Deficiency) Full Gene Sequence Gp1bb (Glycoprotein Ib [Platelet] Beta Polypeptide) (Eg Bernard-Soulier Syndrome Type B) Full Gene Sequence (For Common Deletion Variants Of Alpha Globin 1 And Alpha Globin 2 Genes Use 81257) Hnf1b (Hnf1 Homeobox B) (Eg Maturity-Onset Diabetes Of The Young [Mody]) Duplication Deletion Analysis Hras (V-Ha-Ras Harvey Rat Sarcoma Viral Oncogene Homolog) (Eg Costello Syndrome) Full Gene Sequence Hsd3b2 (Hydroxy-Delta-5-Steroid Dehydrogenase 3 Beta- And Steroid Delta-Isomerase 2) (Eg 3-Beta-Hydroxysteroid Dehydrogenase Type Ii Deficiency) Full Gene Sequence Hsd11b2 (Hydroxysteroid [11-Beta] Dehydrogenase 2) (Eg Mineralocorticoid Excess Syndrome) Full Gene Sequence Hspb1 (Heat Shock 27kda Protein 1) (Eg Charcot-Marie-Tooth Disease) Full Gene Sequence Ins (Insulin) (Eg Diabetes Mellitus) Full Gene Sequence Kcnj1 (Potassium Inwardly-Rectifying Channel Subfamily J Member 1) (Eg Bartter Syndrome) Full Gene Sequence Kcnj10 (Potassium Inwardly-Rectifying Channel Subfamily J Member 10) (Eg Sesame Syndrome East Syndrome Sensorineural Hearing Loss) Full Gene Sequence Litaf (Lipopolysaccharide-Induced Tnf Factor) (Eg Charcot-Marie-Tooth) Full Gene Sequence Mefv (Mediterranean Fever) (Eg Familial Mediterranean Fever) Full Gene Sequence Men1 (Multiple Endocrine Neoplasia I) (Eg Multiple Endocrine Neoplasia Type 1 Wermer Syndrome) Duplication Deletion Analysis Mmachc (Methylmalonic Aciduria [Cobalamin Deficiency] Cblc Type With Homocystinuria) (Eg Methylmalonic Acidemia And Homocystinuria) Full Gene Sequence Mpv17 (Mpv17 Mitochondrial Inner Membrane Protein) (Eg Mitochondrial Dna Depletion Syndrome) Duplication Deletion Analysis Ndp (Norrie Disease [Pseudoglioma]) (Eg Norrie Disease) Full Gene Sequence Ndufa1 (Nadh Dehydrogenase [Ubiquinone] 1 Alpha Subcomplex 1 7.5kda) (Eg Leigh Syndrome Mitochondrial Complex I Deficiency) Full Gene Sequence Ndufaf2 (Nadh Dehydrogenase [Ubiquinone] 1 Alpha Subcomplex Assembly Factor 2) (Eg Leigh Syndrome Mitochondrial Complex I Deficiency) Full Gene Sequence Ndufs4 (Nadh Dehydrogenase [Ubiquinone] Fe-S Protein 4 18kda [Nadh-Coenzyme Q Reductase]) (Eg Leigh Syndrome Mitochondrial Complex I Deficiency) Full Gene Sequence Nipa1 (Non-Imprinted In Prader-Willi Angelman Syndrome 1) (Eg Spastic Paraplegia) Full Gene Sequence Nlgn4x (Neuroligin 4 X-Linked) (Eg Autism Spectrum Disorders) Duplication Deletion Analysis Npc2 (Niemann-Pick Disease Type C2 [Epididymal Secretory Protein E1]) (Eg Niemann-Pick Disease Type C2) Full Gene Sequence Nr0b1 (Nuclear Receptor Subfamily 0 Group B Member 1) (Eg Congenital Adrenal Hypoplasia) Full Gene Sequence Pdx1 (Pancreatic And Duodenal Homeobox 1) (Eg Maturity-Onset Diabetes Of The Young [Mody]) Full Gene Sequence Phox2b (Paired-Like Homeobox 2b) (Eg Congenital Central Hypoventilation Syndrome) Full Gene Sequence Plp1 (Proteolipid Protein 1) (Eg Pelizaeus-Merzbacher Disease Spastic Paraplegia) Duplication Deletion Analysis Pqbp1 (Polyglutamine Binding Protein 1) (Eg Renpenning Syndrome) Duplication Deletion Analysis Prnp (Prion Protein) (Eg Genetic Prion Disease) Full Gene Sequence Prop1 (Prop Paired-Like Homeobox 1) (Eg Combined Pituitary Hormone Deficiency) Full Gene Sequence Prph2 (Peripherin 2 [Retinal Degeneration Slow]) (Eg Retinitis Pigmentosa) Full Gene Sequence Prss1 (Protease Serine 1 [Trypsin 1]) (Eg Hereditary Pancreatitis) Full Gene Sequence Raf1 (V-Raf-1 Murine Leukemia Viral Oncogene Homolog 1) (Eg Leopard Syndrome) Targeted Sequence Analysis (Eg Exons 7 12 14 17) Ret (Ret Proto-Oncogene) (Eg Multiple Endocrine Neoplasia Type 2b And Familial Medullary Thyroid Carcinoma) Common Variants (Eg M918t 2647 2648delinstt A883f) Rho (Rhodopsin) (Eg Retinitis Pigmentosa) Full Gene Sequence Rp1 (Retinitis Pigmentosa 1) (Eg Retinitis Pigmentosa) Full Gene Sequence Scn1b (Sodium Channel Voltage-Gated Type I Beta) (Eg Brugada Syndrome) Full Gene Sequence Sco2 (Sco Cytochrome Oxidase Deficient Homolog 2 [Sco1l]) (Eg Mitochondrial Respiratory Chain Complex Iv Deficiency) Full Gene Sequence Sdhc (Succinate Dehydrogenase Complex Subunit C Integral Membrane Protein 15kda) (Eg Hereditary Paraganglioma-Pheochromocytoma Syndrome) Duplication Deletion Analysis Sdhd (Succinate Dehydrogenase Complex Subunit D Integral Membrane Protein) (Eg Hereditary Paraganglioma) Full Gene Sequence Sgcg (Sarcoglycan Gamma [35kda Dystrophin-Associated Glycoprotein]) (Eg Limb-Girdle Muscular Dystrophy) Duplication Deletion Analysis Sh2d1a (Sh2 Domain Containing 1a) (Eg X-Linked Lymphoproliferative Syndrome) Full Gene Sequence Slc16a2 (Solute Carrier Family 16 Member 2 [Thyroid Hormone Transporter]) (Eg Specific Thyroid Hormone Cell Transporter Deficiency Allan-Herndon-Dudley Syndrome) Duplication Deletion Analysis Slc25a20 (Solute Carrier Family 25 [Carnitine Acylcarnitine Translocase] Member 20) (Eg Carnitine-Acylcarnitine Translocase Deficiency) Duplication Deletion Analysis Slc25a4 (Solute Carrier Family 25 [Mitochondrial Carrier Adenine Nucleotide Translocator] Member 4) (Eg Progressive External Ophthalmoplegia) Full Gene Sequence Sod1 (Superoxide Dismutase 1 Soluble) (Eg Amyotrophic Lateral Sclerosis) Full Gene Sequence Spink1 (Serine Peptidase Inhibitor Kazal Type 1) (Eg Hereditary Pancreatitis) Full Gene Sequence Stk11 (Serine Threonine Kinase 11) (Eg Peutz-Jeghers Syndrome) Duplication Deletion Analysis Taco1 (Translational Activator Of Mitochondrial Encoded Cytochrome C Oxidase I) (Eg Mitochondrial Respiratory Chain Complex Iv Deficiency) Full Gene Sequence Thap1 (Thap Domain Containing Apoptosis Associated Protein 1) (Eg Torsion Dystonia) Full Gene Sequence Tor1a (Torsin Family 1 Member A [Torsin A]) (Eg Torsion Dystonia) Full Gene Sequence Ttpa (Tocopherol [Alpha] Transfer Protein) (Eg Ataxia) Full Gene Sequence Ttr (Transthyretin) (Eg Familial Transthyretin Amyloidosis) Full Gene Sequence Twist1 (Twist Homolog 1 [Drosophila]) (Eg Saethre-Chotzen Syndrome) Full Gene Sequence Tyr (Tyrosinase [Oculocutaneous Albinism Ia]) (Eg Oculocutaneous Albinism Ia) Full Gene Sequence Ugt1a1 (Udp Glucuronosyltransferase 1 Family Polypeptide A1) (Eg Hereditary Unconjugated Hyperbilirubinemia [Crigler-Najjar Syndrome]) Full Gene Sequence Ush1g (Usher Syndrome 1g [Autosomal Recessive]) (Eg Usher Syndrome Type 1) Full Gene Sequence Vhl (Von Hippel-Lindau Tumor Suppressor) (Eg Von Hippel-Lindau Familial Cancer Syndrome) Full Gene Sequence Vwf (Von Willebrand Factor) (Eg Von Willebrand Disease Type 1c) Targeted Sequence Analysis (Eg Exons 26 27 37) Zeb2 (Zinc Finger E-Box Binding Homeobox 2) (Eg Mowat-Wilson Syndrome) Duplication Deletion Analysis Znf41 (Zinc Finger Protein 41) (Eg X-Linked Intellectual Disability 89) Full Gene SequenceSign up free to see the CPT description

Medicaid rate by state

814048 jurisdictions shown, more may be in the platform
Comparable rates shown
8
Shown lowest
$219.86
Shown median
$274.83
Shown highest
$404.09
Alaska: not shown here - Alaska's full fee schedule is in the platformAlabama: not shown here - Alabama's full fee schedule is in the platformArkansas: $378.79, effective September 2026Arizona: not shown here - Arizona's full fee schedule is in the platformCalifornia: not shown here - California's full fee schedule is in the platformColorado: not shown here - Colorado's full fee schedule is in the platformConnecticut: not shown here - Connecticut's full fee schedule is in the platformDistrict of Columbia: not shown here - District of Columbia's full fee schedule is in the platformDelaware: not shown here - Delaware's full fee schedule is in the platformFlorida: not shown here - Florida's full fee schedule is in the platformGeorgia: not shown here - Georgia's full fee schedule is in the platformHawaii: $274.83, effective June 2026Iowa: not shown here - Iowa's full fee schedule is in the platformIdaho: $237.46, effective October 2026Illinois: not shown here - Illinois's full fee schedule is in the platformIndiana: $274.83, effective September 2026Kansas: $404.09 (ordinary statewide rate; $303.07 to $404.09 by rate type), effective October 2026Kentucky: not shown here - Kentucky's full fee schedule is in the platformLouisiana: not shown here - Louisiana's full fee schedule is in the platformMassachusetts: not shown here - Massachusetts's full fee schedule is in the platformMaryland: not shown here - Maryland's full fee schedule is in the platformMaine: not shown here - Maine's full fee schedule is in the platformMichigan: not shown here - Michigan's full fee schedule is in the platformMinnesota: $274.83, effective September 2026Missouri: not shown here - Missouri's full fee schedule is in the platformMississippi: not shown here - Mississippi's full fee schedule is in the platformMontana: not shown here - Montana's full fee schedule is in the platformNorth Carolina: not shown here - North Carolina's full fee schedule is in the platformNorth Dakota: not shown here - North Dakota's full fee schedule is in the platformNebraska: not shown here - Nebraska's full fee schedule is in the platformNew Hampshire: not shown here - New Hampshire's full fee schedule is in the platformNew Jersey: not shown here - New Jersey's full fee schedule is in the platformNew Mexico: not shown here - New Mexico's full fee schedule is in the platformNevada: not shown here - Nevada's full fee schedule is in the platformNew York: not shown here - New York's full fee schedule is in the platformOhio: not shown here - Ohio's full fee schedule is in the platformOklahoma: not shown here - Oklahoma's full fee schedule is in the platformOregon: $219.86, effective September 2026Pennsylvania: not shown here - Pennsylvania's full fee schedule is in the platformRhode Island: not shown here - Rhode Island's full fee schedule is in the platformSouth Carolina: not shown here - South Carolina's full fee schedule is in the platformSouth Dakota: not shown here - South Dakota's full fee schedule is in the platformTexas: not shown here - Texas's full fee schedule is in the platformUtah: not shown here - Utah's full fee schedule is in the platformVirginia: not shown here - Virginia's full fee schedule is in the platformVermont: $267.96, effective October 2026Washington: not shown here - Washington's full fee schedule is in the platformWisconsin: not shown here - Wisconsin's full fee schedule is in the platformWest Virginia: not shown here - West Virginia's full fee schedule is in the platformWyoming: not shown here - Wyoming's full fee schedule is in the platformAKALARAZCACOFLGAIAID$237.46ILINKS$404.09KYLAMEMIMN$274.83MOMSMTNCNDNENMNVNYOHOKOR$219.86PASCSDTN!TXUTVAWAWIWVWY
Small states:CTDCDEHI$274.83MAMDNHNJRIVT$267.96
No published rateNot shown hereNot loaded yetNo schedule published

Ranked by rate

shown median $274.83
  1. KS$404.09
  2. AR$378.79
  3. HI$274.83
  4. IN$274.83
  5. MN$274.83
  6. VT$267.96
  7. ID$237.46
  8. OR$219.86

Hatched states are not shown here. Flat grey means no single comparable rate is available for 81404.

Rate history for one state

Select a state on the map to see how its rate has moved - the platform holds 195 published periods back to 2001. Not part of the free view.

Historical rates are part of the platform

The table behind this panel shows the fields available in historical schedules; it does not display synthetic dates or rates. The real history, every published schedule back to 2001 for all 17,674 codes, is in the platform.

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The 8 jurisdictions shown in full

JurisdictionPrior authNon-facility rate
KansasJan 1, 2013
$303.07 to $404.09 across 3 rate types
Max Fee
$404.09
Max Fee with Adjustment · Exempt Physician · 75% of max fee
$303.07
Max Fee with Adjustment · Mid Level Practitioner · 75% of max fee
$303.07
Not published$404.09ordinary statewide rate
ArkansasSeptember 2026Not published$378.79
HawaiiJune 2026Not published$274.83
IndianaOct 1, 2020Required$274.83
MinnesotaJan 1, 2018Not published$274.83
VermontJan 1, 2026Required$267.96
IdahoSep 1, 2025Required$237.46
OregonOct 1, 2024Not published$219.86

Rates by provider, program, modifier, or setting

Check the rate type, modifiers, and place of service before using an amount. These amounts are not interchangeable.

JurisdictionRate typeModifiersNon-facility rateFacility rate
ArkansasGeneral26$26.51—
ArkansasGeneralTC$352.28—

Labels summarize each state's published rate context. Provider specialty lists, place-of-service lists and adjustment codes are in the full dataset. See the full context in the platform

Comparable figures use unmodified non-facility rows. California provider rates and exact modifier tuples are listed separately where published.

More states may price 81404 than are shown here

The platform includes every schedule period published since 2001, plus the section, modifier and facility detail behind each rate.

Book a demo to see all 50 jurisdictions

No comparable statewide physician fee schedule is available for Tennessee. Why.

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.