Virginia Medicaid rate for CPT 99285
Virginia Medicaid pays $119.82 for CPT 99285 in its October 2026 fee-for-service schedule: the 11th-lowest of 42 state Medicaid programs, at 86% of the $138.69 median.
- Non-facility rate
- $119.82
- Rank
- 32 of 42
- vs. state median
- 86%
- vs. VA Medicare
- 65-72%
What Virginia Medicaid publishes for 99285
11th-lowest of 42 · 86% of median
- Schedule
- October 2026
- In effect since
- Jul 1, 2026
- Prior authorization
- Not required
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. DMAS Procedure Fee Files
99285 in neighboring states
Each state's comparable non-facility rate for 99285 in its current schedule.
| State | Rate | vs. Virginia |
|---|---|---|
| Kentucky | $116.04 | -3% |
| North Carolina | $138.64 | +16% |
| West Virginia | $126.15 | +5% |
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 Virginia is $166.26 to $184.24 across its 2 payment localities; Virginia Medicaid's rate is 65-72% of that. The national amount before geographic adjustment is $171.347.
See 99285 Medicare ratesSee Virginia's full schedule: all 8,748 codes, every published period, and commercial payer rates for 99285.
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