G0559 Medicaid Fee Schedule Rates by State
Compare G0559 (Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a different specialty than the practitioner who performed the procedure, within the 90-day global period of the procedure(s), once per 90-day global period, when there has not been a formal transfer of care and requires the following required elements, when possible and applicable: reading available surgical note to understand the relative success of the procedure, the anatomy that was affected, and potential complications that could have arisen due to the unique circumstances of the patient's operation. research the procedure to determine expected post-operative course and potential complications (in the case of doing a post-op for a procedure outside the specialty). evaluate and physically examine the patient to determine whether the post-operative course is progressing appropriately. communicate with the practitioner who performed the procedure if any questions or concerns arise. (list separately in addition to office/outpatient evaluation and management visit, new or established)) 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.
G0559 Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a different specialty than the practitioner who performed the procedure, within the 90-day global period of the procedure(s), once per 90-day global period, when there has not been a formal transfer of care and requires the following required elements, when possible and applicable: reading available surgical note to understand the relative success of the procedure, the anatomy that was affected, and potential complications that could have arisen due to the unique circumstances of the patient's operation. research the procedure to determine expected post-operative course and potential complications (in the case of doing a post-op for a procedure outside the specialty). evaluate and physically examine the patient to determine whether the post-operative course is progressing appropriately. communicate with the practitioner who performed the procedure if any questions or concerns arise. (list separately in addition to office/outpatient evaluation and management visit, new or established) 7 jurisdictions shown - every covered jurisdiction that prices it
Medicaid rate by state
- Rates shown
- 7
- Shown lowest
- $4.09
- Shown median
- $7.61
- Shown highest
- $12.22
Ranked by rate
shown median $7.61- MT$12.22
- DE$9.38
- HI$8.69
- OR$7.61
- OH$6.76
- MI$6.18
- NJ$4.09
Hatched states are not shown here. Flat grey means no single comparable rate is available for G0559.
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 7 jurisdictions shown in full
| Jurisdiction | Prior auth | Non-facility rate |
|---|---|---|
| MontanaJul 1, 2025 | Not required | $12.22 |
| DelawareJanuary 2026 | Not published | $9.38 |
| HawaiiJune 2026 | Not published | $8.69 |
| OregonFeb 1, 2026 | Not published | $7.61 |
| OhioJan 1, 2025 | Not published | $6.76 |
| MichiganSeptember 2026 | Not published | $6.18 |
New JerseyJul 1, 2026$3.76 to $4.42 across 4 rate types
| Not published | $4.09median across rate types |
Comparable figures use unmodified non-facility rows. California provider rates and exact modifier tuples are listed separately where published.
Every state that prices G0559 is shown above
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.
G0559 Medicaid vs. Medicare vs. commercial
- Medicaid · Median of the 7 state rates shown here
- $7.6179% of Medicare
- Medicare · 2026 national, non-facility
- $9.686
- Commercial national average · Mean of 4 national payers
- $10.438118108% of Medicare
The commercial national average is the mean of what BCBS, UnitedHealthcare, Aetna and Cigna publish nationwide: BCBS $12.666906, UnitedHealthcare $9.114596, Aetna $9.860586, Cigna $10.110384.
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 G0559 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