Fee-for-service ratesJanuary 2026
North Carolina Medicaid Fee Schedule
Search current physician rates from the NC Medicaid fee-for-service schedule, see the official source, and compare common CPT codes with other state programs.
- Effective
- January 2026
- Distinct codes
- 8,393
- Published rows
- 10,216
Search a CPT or HCPCS code
Open the national code comparison. The five common codes below show every covered jurisdiction; other codes show the states available in the free preview.
Current NC Medicaid rates for common codes
Each amount is the median unmodified non-facility rate in the January 2026 schedule when the code appears in more than one section.
| Code | Service | Non-facility rate |
|---|---|---|
| 99213 | Office visit, established patient (low complexity) | $54.26 |
| 99214 | Office visit, established patient (moderate complexity) | $81.76 |
| 99203 | Office visit, new patient (low complexity) | $80.86 |
| 99204 | Office visit, new patient (moderate complexity) | $125.39 |
| 99285 | Emergency department visit, high severity with threat to function | $138.64 |
Other high-enrollment Medicaid fee schedules
Explore current state-published rates, effective periods, and official sources.
CaliforniaMedi-Cal - April 2026New YorkNY Medicaid - July 2026TexasTexas Medicaid - July 2026FloridaFlorida Medicaid - January 2026PennsylvaniaPennsylvania Medical Assistance - August 2026IllinoisIllinois Medicaid - July 2026OhioOhio Medicaid - January 2026MichiganMichigan Medicaid - July 2026GeorgiaGeorgia Medicaid - July 2026