Kentucky Medicaid Fee Schedule
Kentucky Medicaid pays $42.63 for an established-patient office visit (99213): 5th-lowest of 45 Medicaid programs, at 60% of the median. Its rates for the most-billed codes are below, ranked against every state.
- Schedule as of
- January 2026
- Codes priced
- 7,515
- 99213 vs. median
- 60% of median
Current Kentucky Medicaid rates for common codes
Each amount is the unmodified non-facility rate in the January 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
| $42.635th-lowest of 45 · 60% of median | Not published |
| 99214 | Office visit, established patient (moderate complexity)1 rate type
| $67.105th-lowest of 45 · 66% of median | Not published |
| 99203 | Office visit, new patient (low complexity)1 rate type
| $79.0413th-lowest of 45 · 88% of median | Not published |
| 99204 | Office visit, new patient (moderate complexity)1 rate type
| $112.2711th-lowest of 45 · 84% of median | Not published |
| 99285 | Emergency department visit, high severity with threat to function1 rate type
| $116.049th-lowest of 42 · 84% of median | Not published |
Dot: Kentucky. Tick: median across state programs. Line: lowest to highest state. Base fee-for-service rates; supplemental payments some states add are not included.
Kentucky is 5th-lowest of 45 for 99213. See where all 7,515 Kentucky Medicaid codes rank.
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Compare any other code across state programs. The free view shows a few states per code; Kentucky's full schedule is in the complete dataset.
Neighboring and high-enrollment Medicaid fee schedules
States bordering Kentucky first, then the largest programs.