Missouri Medicaid Fee Schedule (MO HealthNet)
MO HealthNet pays $75.21 for an established-patient office visit (99213): 19th-highest of 45 Medicaid programs, at 106% of the median. Its rates for the most-billed codes are below, ranked against every state.
- Schedule as of
- October 2026
- Codes priced
- 9,451
- 99213 vs. median
- 106% of median
Current MO HealthNet 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)7 rate types
| $75.21In effect since Jul 1, 202219th-highest of 45 · 106% of median | Not required |
| 99214 | Office visit, established patient (moderate complexity)7 rate types
| $106.15In effect since Jul 1, 202219th-highest of 45 · 105% of median | Not required |
| 99203 | Office visit, new patient (low complexity)7 rate types
| $92.91In effect since Jul 1, 202221st-highest of 45 · 104% of median | Not required |
| 99204 | Office visit, new patient (moderate complexity)7 rate types
| $138.56In effect since Jul 1, 202220th-highest of 45 · 103% of median | Not required |
| 99285 | Emergency department visit, high severity with threat to function | $146.64In effect since Jul 1, 202216th-highest of 42 · 106% of median | Not required |
Dot: Missouri. Tick: median across state programs. Line: lowest to highest state. Base fee-for-service rates; supplemental payments some states add are not included.
Missouri is 19th-highest of 45 for 99213. See where all 9,451 MO HealthNet codes rank.
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Compare any other code across state programs. The free view shows a few states per code; Missouri's full schedule is in the complete dataset.
Neighboring and high-enrollment Medicaid fee schedules
States bordering Missouri first, then the largest programs.