South Carolina Medicaid rate for CPT 12001
Healthy Connections pays $61.63 for CPT 12001 in its October 2026 fee-for-service schedule: the 10th-lowest of 45 state Medicaid programs, at 71% of the $86.45 median.
- Non-facility rate
- $61.63
- Rank
- 36 of 45
- vs. state median
- 71%
- vs. SC Medicare
- 58%
What Healthy Connections publishes for 12001
10th-lowest of 45 · 71% of median
- Schedule
- October 2026
- In effect since
- Jul 1, 2024
$49.30 to $86.28 across 5 rate types
- Pediatric Subspecialty
- $86.28
- General
- $61.63
- Podiatry
- $61.63
- Nurse Midwife
- $49.30
- PA/NP
- $49.30
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. SCDHHS Fee Schedules
12001 in neighboring states
Each state's comparable non-facility rate for 12001 in its current schedule.
| State | Rate | vs. South Carolina |
|---|---|---|
| Georgia | $103.88 | +69% |
| North Carolina | $104.41 | +69% |
12001 in every state
Map and ranking of every state program that prices 12001.
Compare 12001 across states12001 under Medicare
Medicare's 2026 non-facility payment for 12001 in South Carolina is $106.88; Healthy Connections's rate is 58% of that. The national amount before geographic adjustment is $113.897.
See 12001 Medicare ratesSee South Carolina's full schedule: all 8,625 codes, every published period, and commercial payer rates for 12001.
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