A6503 Medicaid Fee Schedule Rates by State
Compare A6503 across covered Medicaid fee-for-service physician schedules. Each figure is the median unmodified non-facility amount in that jurisdiction's latest published schedule.
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.
A6503 not in the free view
Medicaid rate by state
Hatched states are not shown here. Flat grey means the state is shown and publishes no rate for A6503.
Rate history for one state
Select a state on the map to see how its rate has moved - the platform holds 106 published periods back to 2003. 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 2003 for all 16,416 codes, is in the platform.
Schedule a demoNo state shown here publishes a comparable rate for A6503 - an unmodified non-facility one. A state may still price it under a modifier or for facility settings only, which are not comparable across states and are left to the platform; and a schedule only lists what that state reimburses directly, so codes paid through managed care or bundled into another service do not appear at all.
Every state that prices A6503 is shown above
The platform includes every schedule period published since 2003, plus the section, modifier and facility detail behind each rate.
Compare this state-published Medicaid fee-for-service amount with the negotiated commercial rates payers have published for the same code.
Jurisdictions with no published fee schedule
TennCare has bought capitated managed care since 1994, so what a physician is paid is set in each MCO's provider contracts - BlueCare / TennCare Select (BCBST), UnitedHealthcare Community Plan, Wellpoint - rather than by the state. TennCare does direct some rates under 42 CFR 438.6(c): minimum fee schedules for nursing facilities, HCBS providers and behavioral health crisis services, and maximum fee schedules for DME back braces, physical, occupational and speech therapy, and caesarean section deliveries. Physician evaluation and management is on neither list, and no statewide procedure-level physician schedule is published.
There is no comprehensive Tennessee Medicaid physician fee schedule. A Tennessee figure for an ordinary office visit is one MCO's contracted amount with one provider, and has to be labelled that way.
- CMS - Managed Care in Tennessee (2014 profile)Establishes the starting point, in CMS's words: “Tennessee began its Medicaid managed care program, TennCare, in 1994. Its managed care program is statewide and mandatory for all coverage groups.” The profile is a 2014 snapshot, so it is cited for that and not for anything current.
- TennCare MCO statewide contractSection 3.1.5.1.6 lists every rate TennCare directs: minimum fee schedules for nursing facilities, HCBS providers and behavioral health crisis services; maximum fee schedules for DME back braces, physical, occupational and speech therapy, and caesarean section deliveries. Physician evaluation and management appears on neither list.
- TennCare CHOICES cost-neutrality capsWhat TennCare does price directly, it publishes like this: a nursing facility per diem of $294.87 and private duty nursing at $53.27 an hour, alongside per-member cost caps. Real state-set prices, and nothing at the CPT grain.
Maryland sets fee-for-service rates, but stopped publishing them as files. General Provider Transmittal No. 121, effective May 2026, moved the professional services fee schedules to a read-only online embed with no export, and no downloadable schedule remains on the state's document host.
- Maryland General Provider Transmittal No. 121 (PT86-26)The withdrawal of the files, in the state's own words: the fee schedules “will be removed from” the provider resources website, replaced by a centralized site to “manage real-time fee schedule updates”.
- Maryland professional services fee schedule pageThe page itself is what shows the rest: the only data on it is a read-only embedded sheet with no export, and the workbook URLs search engines still index return 404.
Every other jurisdiction outside the table above is one we have not loaded yet, not one that publishes nothing.
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, section, 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