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Fee-for-service rateAs of October 2026

Washington Medicaid rate for CPT 99213

Apple Health pays a median of $53.22 across its rate types for CPT 99213 in its October 2026 fee-for-service schedule: the 10th-lowest of 45 state Medicaid programs, at 75% of the $71.05 median.

Non-facility rate
$53.22
Rank
36 of 45
vs. state median
75%
vs. WA Medicare
49-55%

What Apple Health publishes for 99213

10th-lowest of 45 · 75% of median

10th-lowest of 45 · 75% of median

Schedule
October 2026
Prior authorization
Conditional
$42.65 to $63.79 across 2 rate types
Under 21
$63.79
Ages 21+
$42.65

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. HCA Provider Billing Guides & Fee Schedules

99213 in neighboring states

Each state's comparable non-facility rate for 99213 in its current schedule.

StateRatevs. Washington
Idaho$86.12+62%
Oregon$76.54+44%

99213 under Medicare

Medicare's 2026 non-facility payment for 99213 in Washington is $97.62 to $107.88 across its 2 payment localities; Apple Health's rate is 49-55% of that. The national amount before geographic adjustment is $95.193.

See 99213 Medicare rates

See Washington's full schedule: all 8,727 codes, every published period, and commercial payer rates for 99213.

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Other Apple Health rates