West Virginia Medicaid Fee Schedule
West Virginia Medicaid pays $65.15 for an established-patient office visit (99213): 18th-lowest of 45 Medicaid programs, at 92% of the median. Its rates for the most-billed codes are below, ranked against every state.
- Schedule as of
- April 2026
- Codes priced
- 7,002
- 99213 vs. median
- 92% of median
Current West Virginia Medicaid rates for common codes
Each amount is the unmodified non-facility rate in the April 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 |
|---|---|---|
| 99213 | Office visit, established patient (low complexity)1 rate type
| $65.15In effect since Apr 1, 202618th-lowest of 45 · 92% of median |
| 99214 | Office visit, established patient (moderate complexity) | $93.21In effect since Apr 1, 202617th-lowest of 45 · 92% of median |
| 99203 | Office visit, new patient (low complexity) | $81.25In effect since Apr 1, 202617th-lowest of 45 · 91% of median |
| 99204 | Office visit, new patient (moderate complexity) | $122.98In effect since Apr 1, 202617th-lowest of 45 · 92% of median |
| 99285 | Emergency department visit, high severity with threat to function | $126.15In effect since Apr 1, 202613th-lowest of 42 · 91% of median |
Dot: West Virginia. Tick: median across state programs. Line: lowest to highest state. Base fee-for-service rates; supplemental payments some states add are not included.
West Virginia is 18th-lowest of 45 for 99213. See where all 7,002 West Virginia Medicaid codes rank.
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Compare any other code across state programs. The free view shows a few states per code; West Virginia's full schedule is in the complete dataset.
Neighboring and high-enrollment Medicaid fee schedules
States bordering West Virginia first, then the largest programs.