G0318 Medicaid Fee Schedule Rates by State
Compare G0318 (Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99345, 99350 for home or residence evaluation and management services). (do not report g0318 on the same date of service as other prolonged services for evaluation and management 99358, 99359, 99417). (do not report g0318 for any time unit less than 15 minutes)) 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.
G0318 Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99345, 99350 for home or residence evaluation and management services). (do not report g0318 on the same date of service as other prolonged services for evaluation and management 99358, 99359, 99417). (do not report g0318 for any time unit less than 15 minutes) 8 jurisdictions shown, more may be in the platform
Medicaid rate by state
- Rates shown
- 8
- Shown lowest
- $23.25
- Shown median
- $30.16
- Shown highest
- $42.19
Ranked by rate
shown median $30.16- MT$42.19
- ND$37.17
- SD$31.81
- ID$30.94
- HI$29.38
- IA$26.53
- OH$23.77
- WI$23.25
Hatched states are not shown here. Flat grey means no single comparable rate is available for G0318.
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 walkthroughThe 8 jurisdictions shown in full
| Jurisdiction | Prior auth | Non-facility rate |
|---|---|---|
| MontanaJul 1, 2025 | Not required | $42.19 |
| North DakotaAugust 2026 | Not required | $37.17 |
| South DakotaJul 1, 2026 | Not published | $31.81 |
| IdahoJul 1, 2026 | Not required | $30.94 |
| HawaiiJune 2026 | Not published | $29.38 |
IowaJul 1, 2024$24.14 to $28.40 across 4 rate types
| Not published | $26.53median across rate types |
| OhioJan 1, 2023 | Not published | $23.77 |
| WisconsinJan 1, 2023 | Not published | $23.25 |
Comparable figures use unmodified non-facility rows. California provider rates and exact modifier tuples are listed separately where published.
More states may price G0318 than are shown here
The platform includes every schedule period published since 2001, 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.
G0318 Medicaid vs. Medicare vs. commercial
- Medicaid · Median of the 8 state rates shown here
- $30.1689% of Medicare
- Medicare · 2026 national, non-facility
- $34.069
- Commercial national average · Mean of 4 national payers
- $37.141449109% of Medicare
The commercial national average is the mean of what BCBS, UnitedHealthcare, Aetna and Cigna publish nationwide: BCBS $41.682854, UnitedHealthcare $38.543112, Aetna $33.219916, Cigna $35.119914.
Medicaid figures are unmodified non-facility fee-for-service rates; Medicare's is the national amount before geographic adjustment. The commercial figure is a national average, not a local rate: each payer's figure averages the unmodified, in-network professional rates it publishes for G0318 across the country, and contracted rates vary widely by market, provider and plan.
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