Montana Medicaid Fee Schedule
Montana Medicaid pays $124.79 for an established-patient office visit (99213): 3rd-highest of 45 Medicaid programs, at 176% of the median. Its rates for the most-billed codes are below, ranked against every state.
- Schedule as of
- January 2026
- Codes priced
- 10,452
- 99213 vs. median
- 176% of median
Current Montana 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) | $124.79In effect since Jul 1, 20253rd-highest of 45 · 176% of median | Not required |
| 99214 | Office visit, established patient (moderate complexity) | $175.60In effect since Jul 1, 20253rd-highest of 45 · 173% of median | Not required |
| 99203 | Office visit, new patient (low complexity) | $152.85In effect since Jul 1, 20254th-highest of 45 · 171% of median | Not required |
| 99204 | Office visit, new patient (moderate complexity) | $229.09In effect since Jul 1, 20254th-highest of 45 · 171% of median | Not required |
| 99285 | Emergency department visit, high severity with threat to function | $236.63In effect since Jul 1, 20254th-highest of 42 · 171% of median | Not required |
Dot: Montana. Tick: median across state programs. Line: lowest to highest state. Base fee-for-service rates; supplemental payments some states add are not included.
Montana is 3rd-highest of 45 for 99213. See where all 10,452 Montana Medicaid codes rank.
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Compare any other code across state programs. The free view shows a few states per code; Montana's full schedule is in the complete dataset.
Neighboring and high-enrollment Medicaid fee schedules
States bordering Montana first, then the largest programs.