Washington Medicaid Fee Schedule (Apple Health)
Apple Health pays $42.65 to $63.79 for an established-patient office visit (99213), depending on the rate type. Its median across rate types, $53.22, is the 10th-lowest of 45 Medicaid programs.
- Schedule as of
- October 2026
- Codes priced
- 8,727
- 99213 vs. median
- 75% of median
Current Apple Health 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)$42.65 to $63.79 across 2 rate types
| $53.22Median across rate types10th-lowest of 45 · 75% of median | Conditional |
| 99214 | Office visit, established patient (moderate complexity)$60.65 to $90.78 across 2 rate types
| $75.72Median across rate types9th-lowest of 45 · 75% of median | Conditional |
| 99203 | Office visit, new patient (low complexity)$52.57 to $78.59 across 2 rate types
| $65.58Median across rate types6th-lowest of 45 · 73% of median | Conditional |
| 99204 | Office visit, new patient (moderate complexity)$79.07 to $117.99 across 2 rate types
| $98.53Median across rate types7th-lowest of 45 · 73% of median | Conditional |
| 99285 | Emergency department visit, high severity with threat to function | $99.186th-lowest of 42 · 72% of median | Not published |
Dot: Washington. Tick: median across state programs. Line: lowest to highest state. Base fee-for-service rates; supplemental payments some states add are not included.
Washington's median is 10th-lowest of 45 for 99213. See where all 8,727 Apple Health codes rank.
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Compare any other code across state programs. The free view shows a few states per code; Washington's full schedule is in the complete dataset.
Neighboring and high-enrollment Medicaid fee schedules
States bordering Washington first, then the largest programs.