Vermont Medicaid rate for CPT 99213
Vermont Medicaid pays a median of $79.37 across its rate types for CPT 99213 in its October 2026 fee-for-service schedule: the 15th-highest of 45 state Medicaid programs, at 112% of the $71.05 median.
- Non-facility rate
- $79.37
- Rank
- 15 of 45
- vs. state median
- 112%
- vs. VT Medicare
- 85%
What Vermont Medicaid publishes for 99213
15th-highest of 45 · 112% of median
- Schedule
- October 2026
- In effect since
- Jul 1, 2026
- Prior authorization
- Not required
$60.72 to $79.37 across 4 rate types
- Provider type 000 · Specialty 000 · PAC R
- $79.37
- Provider type 038 · Specialty S13 · PAC R
- $79.37
- Provider type T25 · Specialty S18 · PAC R
- $79.37
- Provider type 037 · Specialty S12 · PAC 3
- $60.72
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. Vermont Medicaid Fee Schedule Lookup
99213 in neighboring states
Each state's comparable non-facility rate for 99213 in its current schedule.
| State | Rate | vs. Vermont |
|---|---|---|
| Massachusetts | $68.11 | -14% |
| New Hampshire | $46.77 | -41% |
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 Vermont is $93.22; Vermont Medicaid's rate is 85% of that. The national amount before geographic adjustment is $95.193.
See 99213 Medicare ratesSee Vermont's full schedule: all 11,875 codes, every published period, and commercial payer rates for 99213.
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