Indiana Medicaid Fee Schedule (Indiana Health Coverage Programs)
Indiana Health Coverage Programs pays $83.88 for an established-patient office visit (99213): 12th-highest of 45 Medicaid programs, at 118% of the median. Its rates for the most-billed codes are below, ranked against every state.
- Schedule as of
- September 2026
- Codes priced
- 12,853
- 99213 vs. median
- 118% of median
Current Indiana Health Coverage Programs rates for common codes
Each amount is the unmodified non-facility rate in the September 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)1 rate type
| $83.88In effect since Jan 1, 202612th-highest of 45 · 118% of median | Not required |
| 99214 | Office visit, established patient (moderate complexity)1 rate type
| $118.14In effect since Jan 1, 202613th-highest of 45 · 117% of median | Not required |
| 99203 | Office visit, new patient (low complexity)1 rate type
| $102.28In effect since Jan 1, 202615th-highest of 45 · 114% of median | Not required |
| 99204 | Office visit, new patient (moderate complexity)1 rate type
| $153.78In effect since Jan 1, 202615th-highest of 45 · 115% of median | Not required |
| 99285 | Emergency department visit, high severity with threat to function | $159.69In effect since Jan 1, 202611th-highest of 42 · 115% of median | Not required |
Dot: Indiana. Tick: median across state programs. Line: lowest to highest state. Base fee-for-service rates; supplemental payments some states add are not included.
Indiana is 12th-highest of 45 for 99213. See where all 12,853 Indiana Health Coverage Programs codes rank.
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Compare any other code across state programs. The free view shows a few states per code; Indiana's full schedule is in the complete dataset.
Neighboring and high-enrollment Medicaid fee schedules
States bordering Indiana first, then the largest programs.