Wisconsin Medicaid rate for CPT 99213
ForwardHealth pays a median of $60.42 across its rate types for CPT 99213 in its August 2026 fee-for-service schedule: the 12th-lowest of 45 state Medicaid programs, at 85% of the $71.05 median.
- Non-facility rate
- $60.42
- Rank
- 34 of 45
- vs. state median
- 85%
- vs. WI Medicare
- 66%
What ForwardHealth publishes for 99213
12th-lowest of 45 · 85% of median
- Schedule
- August 2026
- In effect since
- Jan 1, 2024
$54.39 to $60.42 across 15 rate types
- Rate type FAP · Provider type 71, specialty 000 · 23 places of service
- $60.42
- Rate type FAP · Provider type 71, specialty 000 · Telehealth
- $60.42
- Rate type HLK · Provider type 72, specialty 000 · 27 places of service
- $60.42
- Rate type MED · 2 provider specialties · 23 places of service
- $60.42
- Rate type MED · 2 provider specialties · Place of service 17
- $60.42
- Rate type MED · 2 provider specialties · Telehealth
- $60.42
- Rate type OTH · 2 provider specialties
- $60.42
- Rate type OTH · 2 provider specialties · 18 places of service
- $60.42
- Rate type PT5 · 2 provider specialties · 23 places of service
- $60.42
- Rate type PT6 · 63 provider specialties · 23 places of service
- $60.42
- Rate type PT6 · 63 provider specialties · Place of service 17
- $60.42
- Rate type PT6 · 63 provider specialties · Telehealth
- $60.42
- Rate type PT1 · 2 provider specialties · 23 places of service
- $54.39
- Rate type PT1 · 2 provider specialties · Place of service 17
- $54.39
- Rate type PT1 · 2 provider specialties · Telehealth
- $54.39
8 rate types
- Rate type FAP · Provider type 71, specialty 000 · Under 19 · 23 places of service · Payment adjustment and 61 more (AQ)
- $60.42
- Rate type FAP · Provider type 71, specialty 000 · Under 19 · 23 places of service · Payment adjustment and 27 more (TJ)
- $60.42
- Rate type MED · 2 provider specialties · 18 places of service and 15 more (TH)
- $60.42
- Rate type MED · 2 provider specialties · 18 places of service · HPSA adjustment and 7 more (AQ + TH)
- $60.42
- Rate type PT1 · 8 provider specialties · 23 places of service and 34 more (AQ)
- $54.39
- Rate type PT1 · Provider type 10, specialty 100 · Under 19 · 23 places of service · Payment adjustment and 15 more (TJ)
- $54.39
- Rate type PT1 · Provider type 10, specialty 100 · 18 places of service and 5 more (TH)
- $54.39
- Rate type PT1 · Provider type 10, specialty 100 · 18 places of service · HPSA adjustment and 2 more (AQ + TH)
- $54.39
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. ForwardHealth Maximum Allowable Fee Schedule
99213 in neighboring states
Each state's comparable non-facility rate for 99213 in its current schedule.
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 Wisconsin is $91.06; ForwardHealth's rate is 66% of that. The national amount before geographic adjustment is $95.193.
See 99213 Medicare ratesSee Wisconsin's full schedule: all 7,754 codes, every published period, and commercial payer rates for 99213.
Book a 15-min Medicaid walkthrough