Fee-for-service ratesAs of October 2026
South Carolina Medicaid Fee Schedule (Healthy Connections)
Healthy Connections pays $69.94 on its ordinary schedule for an established-patient office visit (99213), and $55.95 to $97.91 across its rate types. The ordinary rate is the 22nd-lowest of 45 Medicaid programs.
- Schedule as of
- October 2026
- Codes priced
- 8,625
- 99213 vs. median
- 98% of median
Current Healthy Connections 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.
| Code | Service | Non-facility rate |
|---|---|---|
| 99213 | Office visit, established patient (low complexity)$55.95 to $97.91 across 6 rate types
18 rate types
| $69.94Ordinary statewide rateIn effect since Jul 1, 202422nd-lowest of 45 · 98% of median |
| 99214 | Office visit, established patient (moderate complexity)$79.07 to $138.37 across 6 rate types
18 rate types
| $98.84Ordinary statewide rateIn effect since Jul 1, 202422nd-lowest of 45 · 98% of median |
| 99203 | Office visit, new patient (low complexity)$65.03 to $113.81 across 6 rate types
13 rate types
| $81.29Ordinary statewide rateIn effect since Jul 1, 202418th-lowest of 45 · 91% of median |
| 99204 | Office visit, new patient (moderate complexity)$97.81 to $171.16 across 6 rate types
13 rate types
| $122.26Ordinary statewide rateIn effect since Jul 1, 202416th-lowest of 45 · 91% of median |
| 99285 | Emergency department visit, high severity with threat to function$103.30 to $180.78 across 6 rate types
12 rate types
| $129.13Ordinary statewide rateIn effect since Jul 1, 202416th-lowest of 42 · 93% of median |
Dot: South Carolina. Tick: median across state programs. Line: lowest to highest state. Base fee-for-service rates; supplemental payments some states add are not included.
South Carolina is 22nd-lowest of 45 for 99213. See where all 8,625 Healthy Connections codes rank.
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Compare any other code across state programs. The free view shows a few states per code; South Carolina's full schedule is in the complete dataset.
Neighboring and high-enrollment Medicaid fee schedules
States bordering South Carolina first, then the largest programs.
GeorgiaGeorgia Medicaid - July 2026North CarolinaNC Medicaid - January 2026CaliforniaMedi-Cal - September 2026New YorkNY Medicaid - October 2026TexasTexas Medicaid - September 2026FloridaFlorida Medicaid - July 2026PennsylvaniaPennsylvania Medical Assistance - October 2026IllinoisIllinois Medicaid - July 2026OhioOhio Medicaid - January 2026MichiganMichigan Medicaid - September 2026