New Jersey Medicaid rate for CPT 99213
NJ FamilyCare pays a median of $68.59 across its rate types for CPT 99213 in its July 2026 fee-for-service schedule: the 20th-lowest of 45 state Medicaid programs, at 97% of the $71.05 median.
- Non-facility rate
- $68.59
- Rank
- 26 of 45
- vs. state median
- 97%
- vs. NJ Medicare
- 65-67%
What NJ FamilyCare publishes for 99213
20th-lowest of 45 · 97% of median
- Schedule
- July 2026
- In effect since
- Jul 1, 2026
$63.03 to $74.15 across 4 rate types
- Children Specialist or Purchase
- $74.15
- Fee Specialist or Purchase
- $74.15
- Children Non Specialist or Rental
- $63.03
- Fee Non Specialist or Rental
- $63.03
20 rate types
- Children Non Specialist or Rental and 1 more (FP + 22)
- $209.91
- Children Non Specialist or Rental and 1 more (FP + 52)
- $162.07
- Children Non Specialist or Rental and 3 more (FP + SB)
- $190.67
- Children Non Specialist or Rental (FP)
- $162.07
- Children Non Specialist or Rental and 3 more (HF + HV)
- $90.69
- Children Non Specialist or Rental and 3 more (HF + SA)
- $85.38
- Children Non Specialist or Rental and 3 more (HF)
- $90.69
- Children Non Specialist or Rental and 3 more (SA + UC)
- $85.38
- Children Non Specialist or Rental and 3 more (SA + UD)
- $63.03
- Children Non Specialist or Rental and 3 more (SA)
- $63.03
- Children Non Specialist or Rental and 3 more (SB + 52)
- $74.15
- Children Non Specialist or Rental and 3 more (SB)
- $74.15
- Children Non Specialist or Rental and 1 more (U9)
- $74.15
- Children Non Specialist or Rental (UC)
- $59.06
- Children Non Specialist or Rental and 1 more (UD)
- $162.07
- Children Specialist or Purchase and 1 more (FP + 52)
- $190.67
- Children Specialist or Purchase and 2 more (FP)
- $190.67
- Children Specialist or Purchase (UC)
- $69.48
- Children Specialist or Purchase and 1 more (UD)
- $190.67
- Fee Non Specialist or Rental and 1 more (UC)
- $100.56
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. NJMMIS Procedure Master
99213 in neighboring states
Each state's comparable non-facility rate for 99213 in its current schedule.
| State | Rate | vs. New Jersey |
|---|---|---|
| Delaware | $92.63 | +35% |
| Pennsylvania | $35.00 | -49% |
99213 in every state
Map and ranking of every state program that prices 99213.
Compare 99213 across states99213 under Medicare
Medicare's 2026 non-facility payment for 99213 in New Jersey is $101.71 to $105.93 across its 2 payment localities; NJ FamilyCare's rate is 65-67% of that. The national amount before geographic adjustment is $95.193.
See 99213 Medicare ratesSee New Jersey's full schedule: all 12,793 codes, every published period, and commercial payer rates for 99213.
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