Idaho Medicaid Fee Schedule
Idaho Medicaid pays $86.12 for an established-patient office visit (99213): 11th-highest of 45 Medicaid programs, at 121% of the median. Its rates for the most-billed codes are below, ranked against every state.
- Schedule as of
- October 2026
- Codes priced
- 12,409
- 99213 vs. median
- 121% of median
Current Idaho Medicaid 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) | $86.12In effect since Jul 1, 202611th-highest of 45 · 121% of median | Not required |
| 99214 | Office visit, established patient (moderate complexity) | $122.69In effect since Jul 1, 202611th-highest of 45 · 121% of median | Not required |
| 99203 | Office visit, new patient (low complexity) | $105.65In effect since Jul 1, 202613th-highest of 45 · 118% of median | Not required |
| 99204 | Office visit, new patient (moderate complexity) | $159.87In effect since Jul 1, 202613th-highest of 45 · 119% of median | Not required |
| 99285 | Emergency department visit, high severity with threat to function | $139.24In effect since Jul 1, 202620th-highest of 42 · 100% of median | Not required |
Dot: Idaho. Tick: median across state programs. Line: lowest to highest state. Base fee-for-service rates; supplemental payments some states add are not included.
Idaho is 11th-highest of 45 for 99213. See where all 12,409 Idaho Medicaid codes rank.
Book a 15-min Medicaid walkthroughSearch a CPT or HCPCS code
Compare any other code across state programs. The free view shows a few states per code; Idaho's full schedule is in the complete dataset.
Neighboring and high-enrollment Medicaid fee schedules
States bordering Idaho first, then the largest programs.