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Fee-for-service rateAs of January 2026

Kentucky Medicaid rate for CPT 99213

Kentucky Medicaid pays $42.63 for CPT 99213 in its January 2026 fee-for-service schedule: the 5th-lowest of 45 state Medicaid programs, at 60% of the $71.05 median.

Non-facility rate
$42.63
Rank
41 of 45
vs. state median
60%
vs. KY Medicare
48%

What Kentucky Medicaid publishes for 99213

5th-lowest of 45 · 60% of median

5th-lowest of 45 · 60% of median

Schedule
January 2026
Prior authorization
Not published
1 rate type
Standard rate
Facility $40.36

Unmodified non-facility fee-for-service rate from the state's published file. Managed-care contracts, supplemental payments, and claim-specific adjustments can change what is paid. DMS Fees & Rates

99213 in neighboring states

Each state's comparable non-facility rate for 99213 in its current schedule.

StateRatevs. Kentucky
Illinois$44.67+5%
Indiana$83.88+97%
Missouri$75.21+76%
Ohio$46.23+8%
Virginia$68.63+61%
West Virginia$65.15+53%

99213 under Medicare

Medicare's 2026 non-facility payment for 99213 in Kentucky is $89.52; Kentucky Medicaid's rate is 48% of that. The national amount before geographic adjustment is $95.193.

See 99213 Medicare rates

See Kentucky's full schedule: all 7,515 codes, every published period, and commercial payer rates for 99213.

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Other Kentucky Medicaid rates