99214 Medicaid Fee Schedule Rates by State
Compare 99214 (Office visit, established patient (moderate complexity)) 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 99213, 99214, 99203, 99204, 99285 and up to 8 jurisdictions for other published codes.
99214 Office visit, established patient (moderate complexity) 363 published rates across 46 jurisdictions
Medicaid rate by state
- Jurisdictions compared
- 46
- Lowest comparable
- $51.86
- Median of 45
- $101.32
- Highest comparable
- $236.62
- Comparable spread
- 4.6x
Ranked by rate
comparable median $101.32Rate choices are placed by their lowest published non-facility fee.
- AK$236.62
- NM$182.19
- MT$175.60
- AL$164.23
- ND$149.45
- NE$140.36
- RI$138.53
- MD$133.26
- DE$131.96
- SD$127.87
- ID$122.69
- OK$119.30
- IN$118.14
- GA$115.71
- VT$112.91
- MS$112.59
- WY$111.54
- OR$108.91
- MO$106.15
- MN$105.22
- CO$104.54
- LA$102.83
- UT$101.32
- SC$98.84
- VA$97.76
- NJ$97.55
- MA$96.15
- HI$95.68
- WV$93.21
- NV$90.35
- CT$89.68
- MI$86.48
- AZ$85.81
- WI$85.58
- NC$81.76
- AR$75.76
- WA$75.72
- KS$72.10
- NH$72.03
- OH$70.11
- KY$67.10
- IL$65.79
- IA$65.13
- PA$54.42
- TX$51.86
- CA$37.50to $115.88
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.
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.
Book a 15-min Medicaid walkthrough45 jurisdictions with comparable rates for 99214
| Jurisdiction | Prior auth | Non-facility rate |
|---|---|---|
| AlaskaJuly 2026 | Not published | $236.62 |
| New MexicoJan 1, 2025 | Not published | $182.19 |
| MontanaJul 1, 2025 | Not required | $175.60 |
| AlabamaSeptember 2026 | Not required | $164.23 |
| North DakotaAugust 2026 | Not required | $149.45 |
| NebraskaJuly 2026 | Not required | $140.36 |
Rhode IslandJul 1, 2026$128.78 to $138.53 across 3 rate types
| Not published | $138.53median across rate types |
MarylandSeptember 2026$133.26 to $136.43 across 2 rate types
| Not required | $133.26ordinary statewide rate |
| DelawareJanuary 2026 | Not published | $131.96 |
| South DakotaJul 1, 2026 | Not published | $127.87 |
| IdahoJul 1, 2026 | Not required | $122.69 |
| OklahomaJul 1, 2026 | Not published | $119.30 |
| IndianaJan 1, 2026 | Not required | $118.14 |
GeorgiaJul 1, 2025$115.71 to $118.20 across 3 rate types
| Not published | $115.71ordinary statewide rate |
VermontJul 1, 2026$93.74 to $112.91 across 4 rate types
| Not required | $112.91median across rate types |
MississippiJul 1, 2026$112.59 to $125.10 across 2 rate types
| Not published | $112.59ordinary statewide rate |
WyomingJul 1, 2026$111.30 to $146.82 across 3 rate types
| Not required | $111.54ordinary statewide rate |
OregonFeb 1, 2026$108.91 to $114.50 across 2 rate types
| Not published | $108.91ordinary statewide rate |
| MissouriJul 1, 2022 | Not required | $106.15 |
| MinnesotaFeb 1, 2026 | Not published | $105.22 |
| ColoradoJul 1, 2026 | Not published | $104.54 |
| LouisianaJul 1, 2025 | Not required | $102.83 |
UtahJul 1, 2026$95.58 to $107.05 across 2 rate types
| Not required | $101.32median across rate types |
South CarolinaJul 1, 2024$79.07 to $138.37 across 6 rate types
| Not published | $98.84ordinary statewide rate |
VirginiaJul 1, 2026$97.71 to $97.81 across 2 rate types
| Not required | $97.76median across rate types |
New JerseyJul 1, 2026$89.64 to $105.46 across 4 rate types
| Not published | $97.55median across rate types |
| MassachusettsOct 1, 2026 | Not published | $96.15 |
| HawaiiJune 2026 | Not published | $95.68 |
| West VirginiaApr 1, 2026 | Not published | $93.21 |
NevadaJan 1, 2024$69.95 to $110.75 across 4 rate types
| Not published | $90.35median across rate types |
ConnecticutJan 1, 2026$79.71 to $152.78 across 4 rate types
| Not required | $89.68median across rate types |
| MichiganSeptember 2026 | Not published | $86.48 |
ArizonaOct 1, 2024$81.50 to $95.35 across 7 rate types
| Not published | $85.81median across rate types |
WisconsinJan 1, 2024$77.00 to $85.58 across 11 rate types
| Not published | $85.58median across rate types |
| North CarolinaOct 1, 2025 | Not published | $81.76 |
| ArkansasSeptember 2026 | Not published | $75.76 |
WashingtonOctober 2026$60.65 to $90.78 across 2 rate types
| Conditional | $75.72median across rate types |
KansasAug 1, 2024$54.08 to $72.10 across 4 rate types
| Not published | $72.10ordinary statewide rate |
| New HampshireJul 1, 2023 | Not required | $72.03 |
| OhioJan 1, 2024 | Not published | $70.11 |
| KentuckyJanuary 2026 | Not published | $67.10 |
| IllinoisApr 1, 2024 | Not published | $65.79 |
IowaOct 1, 2025$56.78 to $66.80 across 6 rate types
| Not published | $65.13median across rate types |
| PennsylvaniaFeb 17, 2025 | Not published | $54.42 |
TexasSep 1, 2023$47.68 to $56.03 across 4 rate types
| Not published | $51.86median 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.
| Jurisdiction | Rate type | Modifiers | Non-facility rate | Facility rate |
|---|---|---|---|---|
| Arkansas | General | TH | $128.79 | — |
| Arkansas | General | U4 + UB + X2 | $73.55 | — |
| Arkansas | General | U4 + UB + X4 | $73.55 | — |
| Arkansas | General | U4 + UB | $75.76 | — |
| Arkansas | General | X2 | $73.55 | — |
| Arkansas | General | X4 | $73.55 | — |
| California | 3 rate contexts at this amount
| None | $37.50 | $37.50 |
| California | Allied Health Other Programs · Hospital Emergency Room | None | — | $37.50 |
| California | 2 rate contexts at this amount
| None | $115.88 | $115.88 |
| California | Justice Involved · Hospital Emergency Room | None | — | $115.88 |
| California | 2 rate contexts at this amount
| None | $40.91 | $40.91 |
| California | Medicine (Physician) · Hospital Emergency Room | None | — | $46.58 |
| Colorado | Family Planning Professional | FP + GT | $135.55 | — |
| Colorado | Family Planning Professional | FP | $130.11 | — |
| Colorado | General | GT | $109.44 | — |
| Connecticut | Rate type FTM | None | — | $59.17 |
| Connecticut | Rate type FTO | None | — | $113.41 |
| Connecticut | Rate type FTP | None | — | $73.97 |
| Georgia | Enhanced rate · Facility Place of Service (POS) | None | — | $88.91 |
| Illinois | Prenatal Subsequent | U5 | $104.96 | — |
| Indiana | General | SE | $118.14 | $89.21 |
| Kansas | Max Fee | TD | $66.15 | — |
| Kansas | 3 rate contexts at this amount
| TD | $49.61 | — |
| Kentucky | Standard rate | None | — | $61.98 |
| Louisiana | 2 rate contexts at this amount
| TH | $102.83 | — |
| Missouri | 2 rate contexts at this amount
| EP | $106.15 | — |
| Missouri | General | GE + EP | $106.15 | — |
| Missouri | 2 rate contexts at this amount
| GE | $106.15 | — |
| Missouri | General | GT + EP | $106.15 | — |
| Missouri | General | GT | $106.15 | — |
| Missouri | General | HA | $106.15 | — |
| Missouri | Podiatry | W2 | $106.15 | — |
| Nebraska | General | EP | $140.36 | — |
| New Hampshire | General | 33 | $89.88 | — |
| New Hampshire | General | HE | $108.46 | — |
| New Hampshire | General | HF | $193.85 | — |
| New Hampshire | General | HW + U1 | $108.46 | — |
| New Hampshire | General | HW + U2 | $108.46 | — |
| New Hampshire | General | HW + U5 | $108.46 | — |
| New Hampshire | General | HW + U6 | $108.46 | — |
| New Hampshire | General | HW + U7 | $108.46 | — |
| New Hampshire | General | U1 | $193.85 | — |
| New Jersey | 2 rate contexts at this amount
| FP + 52 | $230.49 | — |
| New Jersey | 4 rate contexts at this amount
| FP + SB | $271.17 | — |
| New Jersey | 2 rate contexts at this amount
| FP | $230.49 | — |
| New Jersey | 4 rate contexts at this amount
| HF + SA | $125.42 | — |
| New Jersey | 4 rate contexts at this amount
| HF | $131.17 | — |
| New Jersey | 4 rate contexts at this amount
| SA + UC | $125.42 | — |
| New Jersey | 4 rate contexts at this amount
| SA | $89.64 | — |
| New Jersey | 4 rate contexts at this amount
| SB + 52 | $105.46 | — |
| New Jersey | 4 rate contexts at this amount
| SB | $105.46 | — |
| New Jersey | Children Non Specialist or Rental | UC | $82.90 | — |
| New Jersey | 2 rate contexts at this amount
| FP + 52 | $271.17 | — |
| New Jersey | 2 rate contexts at this amount
| FP | $271.17 | — |
| New Jersey | Children Specialist or Purchase | UC | $97.53 | — |
| New Jersey | 2 rate contexts at this amount
| UC | $142.43 | — |
| Nevada | 2 rate contexts at this amount
| U6 | $55.38 | — |
| Nevada | Physician Assistant · Rate type PR1 | U6 | $34.98 | — |
| Pennsylvania | 5 rate contexts at this amount
| FP | $54.42 | — |
| Pennsylvania | 4 rate contexts at this amount
| TH | $54.42 | — |
| Pennsylvania | 4 rate contexts at this amount
| U6 | $54.42 | — |
| Pennsylvania | 3 rate contexts at this amount
| U9 | $54.42 | — |
| Rhode Island | Program MMH015 · Level 4 · PAC S · Up to 1 unit | TD + TF | $100.30 | — |
| Rhode Island | Level 3 · PAC I · Up to 1 unit | 25 + GC | $138.53 | — |
| Rhode Island | Level 3 · PAC I · Up to 1 unit | 25 | $138.53 | — |
| Rhode Island | Level 3 · PAC I · Up to 1 unit | 95 | $138.53 | — |
| Rhode Island | Level 3 · PAC I · Up to 1 unit | AQ | $138.53 | — |
| Rhode Island | Level 3 · PAC I · Up to 1 unit | CR | $138.53 | — |
| Rhode Island | Level 3 · PAC I · Up to 1 unit | GA | $138.53 | — |
| Rhode Island | Level 3 · PAC I · Up to 1 unit | GC | $138.53 | — |
| Rhode Island | Level 3 · PAC I · Up to 1 unit | GT | $138.53 | — |
| Rhode Island | Level 3 · PAC I · Up to 1 unit | SA + 95 | $138.53 | — |
| Rhode Island | Level 4 · PAC S · Up to 1 unit | U8 | $117.75 | — |
| South Carolina | Enhanced | FP | $127.50 | $97.04 |
| South Carolina | Enhanced | GT | $127.50 | $97.04 |
| South Carolina | Enhanced | P4 | $127.50 | $97.04 |
| South Carolina | Enhanced | TH | $127.50 | $97.04 |
| South Carolina | General | FP | $98.84 | $75.23 |
| South Carolina | 2 rate contexts at this amount
| GT | $98.84 | $75.23 |
| South Carolina | General | P4 | $98.84 | $75.23 |
| South Carolina | General | TH | $98.84 | $75.23 |
| South Carolina | 2 rate contexts at this amount
| FP | $79.07 | $60.18 |
| South Carolina | 2 rate contexts at this amount
| GT | $79.07 | $60.18 |
| South Carolina | Nurse Midwife | SB | $68.25 | $47.69 |
| South Carolina | Nurse Midwife | TH | $68.25 | $47.69 |
| South Carolina | PA/NP | P4 | $79.07 | $60.18 |
| South Carolina | PA/NP | TH | $79.07 | $60.18 |
| South Carolina | Pediatric Subspecialty | FP | $138.37 | $105.32 |
| South Carolina | Pediatric Subspecialty | GT | $138.37 | $105.32 |
| South Carolina | Pediatric Subspecialty | P4 | $138.37 | $105.32 |
| South Carolina | Pediatric Subspecialty | TH | $138.37 | $105.32 |
| Texas | Medical Services · Under 21 | FP | $52.86 | $52.86 |
| Texas | Medical Services · Ages 10-20 | TH | $56.03 | $56.03 |
| Texas | Medical Services · Ages 21-55 | TH | $47.68 | $47.68 |
| Texas | Medical Services · Ages 21+ | FP | $47.68 | $47.68 |
| Virginia | Under 21 | None | — | $60.89 |
| Virginia | Ages 21+ | None | — | $60.95 |
| Wisconsin | 45 rate contexts at this amount
| AQ | $85.58 | — |
| Wisconsin | 16 rate contexts at this amount
| TJ | $85.58 | — |
| Wisconsin | 22 rate contexts at this amount
| AQ | $77.00 | — |
| Wisconsin | 8 rate contexts at this amount
| TJ | $77.00 | — |
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
Compare this state-published Medicaid fee-for-service amount with the negotiated commercial rates payers have published for the same code.
99214 Medicaid rates in high-enrollment states
Open a state schedule for its current rate, effective period, methodology, and official source.
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