Fee-for-service ratesAs of April 2026
District of Columbia Medicaid Fee Schedule
Current physician rates from the DC Medicaid fee-for-service schedule, compared with other state programs, with the official source.
- Schedule as of
- April 2026
- Codes priced
- 2,281
Current DC Medicaid rates for common codes
Each amount is the unmodified non-facility rate in the April 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 |
|---|---|---|
| 99213 | Office visit, established patient (low complexity) | Not separately priced |
| 99214 | Office visit, established patient (moderate complexity) | Not separately priced |
| 99203 | Office visit, new patient (low complexity) | Not separately priced |
| 99204 | Office visit, new patient (moderate complexity) | Not separately priced |
| 99285 | Emergency department visit, high severity with threat to function | Not separately priced |
See all 2,281 DC Medicaid codes, every schedule period, in the platform.
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Compare any other code across state programs. The free view shows a few states per code; District of Columbia's full schedule is in the complete dataset.
Neighboring and high-enrollment Medicaid fee schedules
States bordering District of Columbia first, then the largest programs.
MarylandMaryland Medicaid - September 2026VirginiaVirginia Medicaid - October 2026CaliforniaMedi-Cal - September 2026New YorkNY Medicaid - October 2026TexasTexas Medicaid - September 2026FloridaFlorida Medicaid - July 2026PennsylvaniaPennsylvania Medical Assistance - October 2026IllinoisIllinois Medicaid - July 2026North CarolinaNC Medicaid - January 2026OhioOhio Medicaid - January 2026