Texas Medicaid rate for CPT 99213
Texas Medicaid pays a median of $36.92 across its rate types for CPT 99213 in its September 2026 fee-for-service schedule: the 2nd-lowest of 45 state Medicaid programs, at 52% of the $71.05 median.
- Non-facility rate
- $36.92
- Rank
- 44 of 45
- vs. state median
- 52%
- vs. TX Medicare
- 38-41%
What Texas Medicaid publishes for 99213
2nd-lowest of 45 · 52% of median
- Schedule
- September 2026
- In effect since
- Sep 1, 2023
$33.95 to $39.90 across 4 rate types
- Medical Services · Under 21
- $39.90
- Surgery · Ages 10-20
- $39.90
- Medical Services · Ages 21+
- $33.95
- Surgery · Ages 21-55
- $33.95
2 rate types
- Medical Services · Ages 10-20 (TH)
- $39.90
- Medical Services · Ages 21-55 (TH)
- $33.95
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. TMHP Static Fee Schedules
99213 in neighboring states
Each state's comparable non-facility rate for 99213 in its current schedule.
| State | Rate | vs. Texas |
|---|---|---|
| Arkansas | $39.26 | +6% |
| Louisiana | $72.72 | +97% |
| New Mexico | $128.92 | +249% |
| Oklahoma | $83.62 | +126% |
99213 in every state
Map and ranking of every state program that prices 99213.
Compare 99213 across states99213 under Medicare
Medicare's 2026 non-facility payment for 99213 in Texas is $90.59 to $97.77 across its 8 payment localities; Texas Medicaid's rate is 38-41% of that. The national amount before geographic adjustment is $95.193.
See 99213 Medicare ratesSee Texas's full schedule: all 8,435 codes, every published period, and commercial payer rates for 99213.
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