Connecticut Medicaid Fee Schedule (Connecticut Medical Assistance Program)
Connecticut Medical Assistance Program pays $56.71 to $108.70 for an established-patient office visit (99213), depending on the rate type. Its median across rate types, $63.80, is the 16th-lowest of 45 Medicaid programs.
- Schedule as of
- October 2026
- Codes priced
- 8,312
- 99213 vs. median
- 90% of median
Current Connecticut Medical Assistance Program rates for common codes
Each amount is the unmodified non-facility rate in the October 2026 schedule. Where a code appears under more than one rate type, it is the state's ordinary statewide rate when its rules name one, and otherwise the median across rate types. Modifier-specific and facility-only rows are listed separately under the service.
| Code | Service | Non-facility rate | Prior auth |
|---|---|---|---|
| 99213 | Office visit, established patient (low complexity)$56.71 to $108.70 across 4 rate types
3 rate types
| $63.80Median across rate typesIn effect since Jan 1, 202616th-lowest of 45 · 90% of median | Not required |
| 99214 | Office visit, established patient (moderate complexity)$79.71 to $152.78 across 4 rate types
3 rate types
| $89.68Median across rate typesIn effect since Jan 1, 202615th-lowest of 45 · 89% of median | Not required |
| 99203 | Office visit, new patient (low complexity)$69.58 to $133.35 across 4 rate types
3 rate types
| $78.28Median across rate typesIn effect since Jan 1, 202612th-lowest of 45 · 88% of median | Not required |
| 99204 | Office visit, new patient (moderate complexity)$103.99 to $199.31 across 4 rate types
3 rate types
| $116.98Median across rate typesIn effect since Jan 1, 202614th-lowest of 45 · 87% of median | Not required |
| 99285 | Emergency department visit, high severity with threat to function | $106.14In effect since Jan 1, 20268th-lowest of 42 · 77% of median | Not required |
Dot: Connecticut. Tick: median across state programs. Line: lowest to highest state. Base fee-for-service rates; supplemental payments some states add are not included.
Connecticut's median is 16th-lowest of 45 for 99213. See where all 8,312 Connecticut Medical Assistance Program codes rank.
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Neighboring and high-enrollment Medicaid fee schedules
States bordering Connecticut first, then the largest programs.