North Carolina Medicaid rate for CPT 99213
NC Medicaid pays $54.26 for CPT 99213 in its January 2026 fee-for-service schedule: the 11th-lowest of 45 state Medicaid programs, at 76% of the $71.05 median.
- Non-facility rate
- $54.26
- Rank
- 35 of 45
- vs. state median
- 76%
- vs. NC Medicare
- 60%
What NC Medicaid publishes for 99213
11th-lowest of 45 · 76% of median
- Schedule
- January 2026
- In effect since
- Oct 1, 2025
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. NC Medicaid Physician Services Fee Schedules
99213 in neighboring states
Each state's comparable non-facility rate for 99213 in its current schedule.
| State | Rate | vs. North Carolina |
|---|---|---|
| Georgia | $82.05 | +51% |
| South Carolina | $69.94 | +29% |
| Virginia | $68.63 | +26% |
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 North Carolina is $90.84; NC Medicaid's rate is 60% of that. The national amount before geographic adjustment is $95.193.
See 99213 Medicare ratesSee North Carolina's full schedule: all 8,402 codes, every published period, and commercial payer rates for 99213.
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