Fee-for-service rateAs of October 2026

Rhode Island Medicaid rate for CPT 99213

Office visit, established patient (low complexity)

Rhode Island Medicaid pays a median of $97.30 across its rate types for CPT 99213 in its October 2026 fee-for-service schedule: the 7th-highest of 45 state Medicaid programs, at 137% of the $71.05 median.

Non-facility rate: $97.30
Rank: 7 of 45
vs. state median: 137%
vs. RI Medicare: 100%

What Rhode Island Medicaid publishes for 99213

7th-highest of 45 · 137% of median

Schedule: October 2026
In effect since: Oct 1, 2026

$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

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. EOHHS Fee Schedules

99213 in neighboring states

Each state's comparable non-facility rate for 99213 in its current schedule.

State	Rate	vs. Rhode Island
Connecticut	$63.80	-34%
Massachusetts	$68.11	-30%

99213 in every state

Map and ranking of every state program that prices 99213.

Compare 99213 across states

99213 under Medicare

Medicare's 2026 non-facility payment for 99213 in Rhode Island is $97.30; Rhode Island Medicaid's rate is 100% of that. The national amount before geographic adjustment is $95.193.

See 99213 Medicare rates

See Rhode Island's full schedule: all 12,354 codes, every published period, and commercial payer rates for 99213.

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Other Rhode Island Medicaid rates

99214$138.53 99203$119.95 99204$180.87 99283$38.00 99284$59.20 99285$92.55 93000$16.31 93306$153.15 96372$12.59 20610$25.20 11042$25.20 12001$25.20 29881$336.00 45378$172.14 47562$354.60 64483$115.17 66984$604.34 90834$101.75 90837$135.68