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Fee-for-service ratesAs of October 2026

Rhode Island Medicaid Fee Schedule

Rhode Island Medicaid pays $83.43 to $97.30 for an established-patient office visit (99213), depending on the rate type. Its median across rate types, $97.30, is the 7th-highest of 45 Medicaid programs.

Schedule as of
October 2026
Codes priced
12,354
99213 vs. median
137% of median

Current Rhode Island Medicaid 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.

CodeServiceNon-facility rate
99213Office visit, established patient (low complexity)
$83.43 to $97.30 across 3 rate types
General
$97.30
Program MPR010 · Level 3 · Up to 1 unit
$97.30
Program MMH015 · Level 3 · Up to 1 unit
$83.43
15 rate types
Program MMH015 · Level 4 · PAC S · Up to 1 unit (TD + TF)
$66.30
Level 3 · PAC I · Up to 1 unit (24 + 25)
$97.30
Level 3 · PAC I · Up to 1 unit (24)
$97.30
Level 3 · PAC I · Up to 1 unit (25)
$97.30
Level 3 · PAC I · Up to 1 unit (95)
$97.30
Level 3 · PAC I · Up to 1 unit (AQ)
$97.30
Level 3 · PAC I · Up to 1 unit (CE)
$97.30
Level 3 · PAC I · Up to 1 unit (GA + 24)
$97.30
Level 3 · PAC I · Up to 1 unit (GA + 25)
$97.30
Level 3 · PAC I · Up to 1 unit (GA)
$97.30
Level 3 · PAC I · Up to 1 unit (GC + 95)
$97.30
Level 3 · PAC I · Up to 1 unit (GE)
$97.30
Level 3 · PAC I · Up to 1 unit (GT)
$97.30
Level 3 · PAC I · Up to 1 unit (GY)
$97.30
Level 4 · PAC S · Up to 1 unit (U8)
$82.71
$97.30Median across rate typesIn effect since Oct 1, 20267th-highest of 45 · 137% of median
99214Office visit, established patient (moderate complexity)
$128.78 to $138.53 across 3 rate types
General
$138.53
Program MPR010 · Level 3 · Up to 1 unit
$138.53
Program MMH015 · Level 3 · Up to 1 unit
$128.78
11 rate types
Program MMH015 · Level 4 · PAC S · Up to 1 unit (TD + TF)
$100.30
Level 3 · PAC I · Up to 1 unit (25 + GC)
$138.53
Level 3 · PAC I · Up to 1 unit (25)
$138.53
Level 3 · PAC I · Up to 1 unit (95)
$138.53
Level 3 · PAC I · Up to 1 unit (AQ)
$138.53
Level 3 · PAC I · Up to 1 unit (CR)
$138.53
Level 3 · PAC I · Up to 1 unit (GA)
$138.53
Level 3 · PAC I · Up to 1 unit (GC)
$138.53
Level 3 · PAC I · Up to 1 unit (GT)
$138.53
Level 3 · PAC I · Up to 1 unit (SA + 95)
$138.53
Level 4 · PAC S · Up to 1 unit (U8)
$117.75
$138.53Median across rate typesIn effect since Jul 1, 20267th-highest of 45 · 137% of median
99203Office visit, new patient (low complexity)
4 rate types
Level 3 · PAC I · Up to 1 unit (25)
$119.95
Level 3 · PAC I · Up to 1 unit (GA)
$119.95
Level 3 · PAC I · Up to 1 unit (GT)
$119.95
Level 4 · PAC S · Up to 1 unit (U8)
$101.96
$119.95In effect since Jul 1, 20267th-highest of 45 · 134% of median
99204Office visit, new patient (moderate complexity)
5 rate types
Level 3 · PAC I · Up to 1 unit (25)
$180.87
Level 3 · PAC I · Up to 1 unit (GA)
$180.87
Level 3 · PAC I · Up to 1 unit (GE)
$180.87
Level 3 · PAC I · Up to 1 unit (GT)
$180.87
Level 4 · PAC S · Up to 1 unit (U8)
$153.74
$180.87In effect since Jul 1, 20268th-highest of 45 · 135% of median
99285Emergency department visit, high severity with threat to function
2 rate types
Level 3 · PAC I · Up to 1 unit (25)
$92.55
Level 3 · PAC I · Up to 1 unit (GC)
$92.55
$92.55In effect since Jul 1, 20034th-lowest of 42 · 67% of median

Rhode Island's median is 7th-highest of 45 for 99213. See where all 12,354 Rhode Island Medicaid codes rank.

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Compare any other code across state programs. The free view shows a few states per code; Rhode Island's full schedule is in the complete dataset.

Neighboring and high-enrollment Medicaid fee schedules

States bordering Rhode Island first, then the largest programs.

ConnecticutConnecticut Medical Assistance Program - October 2026MassachusettsMassHealth - October 2026CaliforniaMedi-Cal - September 2026New YorkNY Medicaid - October 2026TexasTexas Medicaid - September 2026FloridaFlorida Medicaid - July 2026PennsylvaniaPennsylvania Medical Assistance - October 2026IllinoisIllinois Medicaid - July 2026North CarolinaNC Medicaid - January 2026OhioOhio Medicaid - January 2026