Utah Medicaid Fee Schedule
Utah Medicaid pays $67.03 to $75.07 for an established-patient office visit (99213), depending on the rate type. Its median across rate types, $71.05, is the 23rd-highest of 45 Medicaid programs.
- Schedule as of
- October 2026
- Codes priced
- 9,338
- 99213 vs. median
- 100% of median
Current Utah Medicaid 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 | Prior auth |
|---|---|---|---|
| 99213 | Office visit, established patient (low complexity)$67.03 to $75.07 across 2 rate types
| $71.05Median across rate typesIn effect since Jul 1, 202623rd-highest of 45 · 100% of median | Not required |
| 99214 | Office visit, established patient (moderate complexity)$95.58 to $107.05 across 2 rate types
| $101.32Median across rate typesIn effect since Jul 1, 202623rd-highest of 45 · 100% of median | Not required |
| 99203 | Office visit, new patient (low complexity)$89.10 to $99.79 across 2 rate types
| $94.45Median across rate typesIn effect since Jul 1, 202619th-highest of 45 · 106% of median | Not required |
| 99204 | Office visit, new patient (moderate complexity)$134.70 to $150.86 across 2 rate types
| $142.78Median across rate typesIn effect since Jul 1, 202618th-highest of 45 · 106% of median | Not required |
| 99285 | Emergency department visit, high severity with threat to function$132.20 to $148.06 across 2 rate types
| $140.13Median across rate typesIn effect since Jul 1, 202619th-highest of 42 · 101% of median | Not required |
Dot: Utah. Tick: median across state programs. Line: lowest to highest state. Base fee-for-service rates; supplemental payments some states add are not included.
Utah's median is 23rd-highest of 45 for 99213. See where all 9,338 Utah Medicaid codes rank.
Book a 15-min Medicaid walkthroughSearch a CPT or HCPCS code
Compare any other code across state programs. The free view shows a few states per code; Utah's full schedule is in the complete dataset.
Neighboring and high-enrollment Medicaid fee schedules
States bordering Utah first, then the largest programs.