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

96372 Medicaid Fee Schedule Rates by State

Compare 96372 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 96372

96372 111 published rates across 44 jurisdictions

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Medicaid rate by state

96372each state's current schedule
Jurisdictions compared
44
Lowest comparable
$3.30
Median of 42
$12.79
Highest comparable
$25.99
Comparable spread
7.9x
Alaska: $25.99, effective July 2026Alabama: no published rate for 96372Arkansas: no published rate for 96372Arizona: $14.34 (median of $14.34 to $15.93 by rate type), effective October 2026California: non-facility rates $18.75 by provider, program, or modifier; exact rates are listed belowColorado: $11.94, effective July 2026Connecticut: $11.57, effective October 2026District of Columbia: no published rate for 96372Delaware: $14.95, effective January 2026Florida: no published rate for 96372Georgia: $17.88, effective July 2026Hawaii: $8.98, effective June 2026Iowa: $3.59 (median of $3.21 to $3.77 by rate type), effective September 2026Idaho: $12.48, effective October 2026Illinois: $9.81, effective July 2026Indiana: $13.11, effective September 2026Kansas: $14.30 (ordinary statewide rate; $10.73 to $14.30 by rate type), effective October 2026Kentucky: $18.10, effective January 2026Louisiana: no published rate for 96372Massachusetts: $10.79, effective October 2026Maryland: $15.75, effective September 2026Maine: no published rate for 96372Michigan: $9.80, effective September 2026Minnesota: $11.83, effective September 2026Missouri: non-facility rates $18.70 by provider, program, or modifier; exact rates are listed belowMississippi: $12.58, effective July 2026Montana: $19.53, effective January 2026North Carolina: $16.53, effective January 2026North Dakota: $16.90, effective August 2026Nebraska: $19.18, effective July 2026New Hampshire: $13.99, effective July 2026New Jersey: $10.95 (median of $6.92 to $16.18 by rate type), effective July 2026New Mexico: $20.07, effective March 2026Nevada: $19.90 (median of $16.47 to $23.33 by rate type), effective July 2026New York: $13.36, effective October 2026Ohio: $13.54, effective January 2026Oklahoma: $13.38, effective July 2026Oregon: $12.40, effective September 2026Pennsylvania: $12.70, effective October 2026Rhode Island: $12.59, effective October 2026South Carolina: $3.72 (ordinary statewide rate; $3.72 to $15.68 by rate type), effective October 2026South Dakota: $14.61, effective July 2026Texas: $11.78 (median of $11.49 to $12.07 by rate type), effective September 2026Utah: $12.29 (median of $11.59 to $12.98 by rate type), effective October 2026Virginia: $13.31, effective October 2026Vermont: $12.88, effective October 2026Washington: $9.36, effective October 2026Wisconsin: $3.30 (median of $3.28 to $3.31 by rate type), effective August 2026West Virginia: $10.25, effective April 2026Wyoming: $12.44, effective September 2026AK$25.99ALARAZ$14.34CA$18.75CO$11.94FLGAIAID$12.48ILINKS$14.30KYLAMEMIMN$11.83MO$18.70MSMT$19.53NCND$16.90NE$19.18NM$20.07NV$19.90NYOHOK$13.38OR$12.40PASCSD$14.61TN!TX$11.78UT$12.29VAWA$9.36WIWVWY$12.44
Small states:CT$11.57DC—DE$14.95HI$8.98MA$10.79MD$15.75NH$13.99NJ$10.95RI$12.59VT$12.88
No published rateRate choicesNot loaded yetNo schedule published

Ranked by rate

comparable median $12.79

Rate choices are placed by their lowest published non-facility fee.

  1. AK$25.99
  2. NM$20.07
  3. NV$19.90
  4. MT$19.53
  5. NE$19.18
  6. CA$18.75
  7. MO$18.70
  8. KY$18.10
  9. GA$17.88
  10. ND$16.90
  11. NC$16.53
  12. MD$15.75
  13. DE$14.95
  14. SD$14.61
  15. AZ$14.34
  16. KS$14.30
  17. NH$13.99
  18. OH$13.54
  19. OK$13.38
  20. NY$13.36
  21. VA$13.31
  22. IN$13.11
  23. VT$12.88
  24. PA$12.70
  25. RI$12.59
  26. MS$12.58
  27. ID$12.48
  28. WY$12.44
  29. OR$12.40
  30. UT$12.29
  31. CO$11.94
  32. MN$11.83
  33. TX$11.78
  34. CT$11.57
  35. NJ$10.95
  36. MA$10.79
  37. WV$10.25
  38. IL$9.81
  39. MI$9.80
  40. WA$9.36
  41. HI$8.98
  42. SC$3.72
  43. IA$3.59
  44. WI$3.30

Blue states show comparable rates or published rate choices. Use the exact rate type below.

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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42 jurisdictions with comparable rates for 96372

JurisdictionPrior authNon-facility rate
AlaskaJuly 2026Not published$25.99
New MexicoJan 1, 2025Not published$20.07
NevadaJan 1, 2024
$16.47 to $23.33 across 4 rate types
APRN · Rate type DEF
$23.33
Rate type DEF
$23.33
Nurse Anesthetist · Rate type NRS
$16.47
Physician Assistant · Rate type PR1
$16.47
Not published$19.90median across rate types
MontanaJul 1, 2025Not required$19.53
NebraskaJuly 2026Not required$19.18
KentuckyJanuary 2026Not published$18.10
GeorgiaJuly 2026Not published$17.88
North DakotaAugust 2026Not required$16.90
North CarolinaOct 1, 2025Not published$16.53
MarylandSeptember 2026Not required$15.75
DelawareJanuary 2026Not published$14.95
South DakotaJul 1, 2026Not published$14.61
ArizonaOct 1, 2026
$14.34 to $15.93 across 7 rate types
General
$15.93
Provider type 08
$15.93
Provider type 31
$15.93
Provider type 09
$14.34
Provider type 18
$14.34
Provider type 19
$14.34
Provider type CN
$14.34
Not published$14.34median across rate types
KansasJan 1, 2009
$10.73 to $14.30 across 3 rate types
Max Fee
$14.30
Max Fee with Adjustment · Exempt Physician · 75% of max fee
$10.73
Max Fee with Adjustment · Mid Level Practitioner · 75% of max fee
$10.73
Not published$14.30ordinary statewide rate
New HampshireJul 1, 2023Not required$13.99
OhioJan 1, 2024Not published$13.54
OklahomaJul 1, 2026Not published$13.38
New YorkOct 1, 2026Not required$13.36
VirginiaJul 1, 2026Not published$13.31
IndianaJan 1, 2026Not required$13.11
VermontJan 1, 2026Not required$12.88
PennsylvaniaOct 1, 2023Not published$12.70
Rhode IslandJan 1, 2009Not published$12.59
MississippiJul 1, 2026Not published$12.58
IdahoJul 1, 2026Not required$12.48
WyomingJul 1, 2026Not required$12.44
OregonFeb 1, 2026Not published$12.40
UtahJul 1, 2026
$11.59 to $12.98 across 2 rate types
Global (Rural)
$12.98
Global
$11.59
Not required$12.29median across rate types
ColoradoJul 1, 2026Not published$11.94
MinnesotaFeb 1, 2026Not published$11.83
TexasMar 1, 2026
$11.49 to $12.07 across 2 rate types
Medical Services · Under 21
$12.07
Medical Services · Ages 21+
$11.49
Not published$11.78median across rate types
ConnecticutJan 1, 2026Not required$11.57
New JerseyJul 1, 2026
$6.92 to $16.18 across 4 rate types
Children Specialist or Purchase
$16.18
Children Non Specialist or Rental
$13.76
Fee Specialist or Purchase
$8.14
Fee Non Specialist or Rental
$6.92
Not published$10.95median across rate types
MassachusettsOct 1, 2026Not published$10.79
West VirginiaApr 1, 2026Not published$10.25
IllinoisJan 1, 2009Not published$9.81
MichiganSeptember 2026Not published$9.80
WashingtonOctober 2026Not published$9.36
HawaiiJune 2026Not published$8.98
South CarolinaJul 11, 2011
$3.72 to $15.68 across 4 rate types
Nurse Midwife
$15.68
PA/NP
$12.55
General
$3.72
Pediatric Subspecialty
$3.72
Not published$3.72ordinary statewide rate
IowaJul 1, 2024
$3.21 to $3.77 across 5 rate types
General
$3.77
Provider type 03
$3.77
Provider type 38
$3.59
Provider type 68
$3.28
Provider type 50
$3.21
Not published$3.59median across rate types
WisconsinJan 1, 2009
$3.28 to $3.31 across 4 rate types
Rate type MED · 5 provider specialties
$3.31
Rate type MED · 6 provider specialties · 32 places of service
$3.31
Rate type FAP · Provider type 71, specialty 000
$3.28
Rate type FAP · Provider type 71, specialty 000 · 32 places of service
$3.28
Not published$3.30median across rate types

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
California
2 rate contexts at this amount
Justice Involved
Medicine (Physician)
None$18.75$18.75
CaliforniaJustice Involved · Hospital Emergency RoomNone—$18.75
CaliforniaMedicine (Physician) · Hospital Emergency RoomNone—$23.77
KansasMax FeeU8$14.30—
Kansas
2 rate contexts at this amount
Max Fee with Adjustment · Exempt Physician · 75% of max fee
Max Fee with Adjustment · Mid Level Practitioner · 75% of max fee
U8$10.73—
KentuckyStandard rateNone—$18.10
MissouriGeneralTT$18.70—
New HampshireGeneralHE$11.66—
New HampshireGeneralHW + U1$11.66—
New HampshireGeneralHW + U2$11.66—
New HampshireGeneralHW + U5$11.66—
New HampshireGeneralHW + U6$11.66—
New HampshireGeneralHW + U7$11.66—
New Jersey
4 rate contexts at this amount
Children Non Specialist or Rental
Children Specialist or Purchase
Fee Non Specialist or Rental
Fee Specialist or Purchase
AG$7.43—
New Jersey
2 rate contexts at this amount
Children Non Specialist or Rental
Fee Non Specialist or Rental
FP$23.96—
New Jersey
2 rate contexts at this amount
Children Non Specialist or Rental
Children Specialist or Purchase
SA$13.07—
New Jersey
4 rate contexts at this amount
Children Non Specialist or Rental
Children Specialist or Purchase
Fee Non Specialist or Rental
Fee Specialist or Purchase
SB$7.83—
New Jersey
2 rate contexts at this amount
Children Specialist or Purchase
Fee Specialist or Purchase
FP$28.19—
New Jersey
2 rate contexts at this amount
Fee Non Specialist or Rental
Fee Specialist or Purchase
SA$6.66—
Rhode IslandLevel 3 · PAC I · Up to 5 units59$12.59—
Rhode IslandLevel 3 · PAC I · Up to 5 unitsPO$12.59—
Rhode IslandLevel 3 · PAC I · Up to 5 unitsXS$12.59—
Rhode IslandLevel 3 · PAC I · Up to 5 unitsXU$12.59—
South Carolina
2 rate contexts at this amount
General
Pediatric Subspecialty
FP$3.72—
South CarolinaNurse MidwifeFP$15.68$15.68
South CarolinaPA/NPFP$2.98—

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

96372 Medicaid vs. Medicare

Medicare's 2026 national non-facility payment for 96372 is $15.364. Medicaid's $12.64, the median across 42 state programs, is 82% of Medicare.

Medicaid figures are unmodified non-facility fee-for-service rates; Medicare's is the national amount before geographic adjustment.

See 96372 Medicare rates

96372 Medicaid rates in high-enrollment states

Open a state schedule for its current rate, effective period, methodology, and official source.

CaliforniaMedi-Cal - September 2026New YorkNY Medicaid - October 2026TexasTexas Medicaid - September 2026PennsylvaniaPennsylvania Medical Assistance - October 2026IllinoisIllinois Medicaid - July 2026North CarolinaNC Medicaid - January 2026OhioOhio Medicaid - January 2026MichiganMichigan Medicaid - September 2026GeorgiaGeorgia Medicaid - July 2026

96372 Medicaid rate by state

AlaskaArizonaCaliforniaColoradoConnecticutDelawareGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

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.