South Carolina Medicaid rate for CPT 99285
Healthy Connections pays $129.13 for CPT 99285 in its October 2026 fee-for-service schedule: the 16th-lowest of 42 state Medicaid programs, at 93% of the $138.69 median.
- Non-facility rate
- $129.13
- Rank
- 27 of 42
- vs. state median
- 93%
- vs. SC Medicare
- 77%
What Healthy Connections publishes for 99285
16th-lowest of 42 · 93% of median
- Schedule
- October 2026
- In effect since
- Jul 1, 2024
$103.30 to $180.78 across 6 rate types
- Pediatric Subspecialty
- $180.78
- Enhanced
- $166.58
- General
- $129.13
- Podiatry
- $129.13
- Nurse Midwife
- $103.30
- PA/NP
- $103.30
12 rate types
- Enhanced (FP)
- $166.58
- Enhanced (GT)
- $166.58
- Enhanced (P4)
- $169.29
- General (FP)
- $129.13
- General and 1 more (GT)
- $129.13
- General (P4)
- $131.23
- Nurse Midwife and 1 more (FP)
- $103.30
- Nurse Midwife and 1 more (GT)
- $103.30
- PA/NP (P4)
- $104.99
- Pediatric Subspecialty (FP)
- $180.78
- Pediatric Subspecialty (GT)
- $180.78
- Pediatric Subspecialty (P4)
- $183.72
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
99285 in neighboring states
Each state's comparable non-facility rate for 99285 in its current schedule.
| State | Rate | vs. South Carolina |
|---|---|---|
| Georgia | $132.41 | +3% |
| North Carolina | $138.64 | +7% |
99285 in every state
Map and ranking of every state program that prices 99285.
Compare 99285 across states99285 under Medicare
Medicare's 2026 non-facility payment for 99285 in South Carolina is $167.29; Healthy Connections's rate is 77% of that. The national amount before geographic adjustment is $171.347.
See 99285 Medicare ratesSee South Carolina's full schedule: all 8,625 codes, every published period, and commercial payer rates for 99285.
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