Wisconsin Medicaid rate for CPT 99285
ForwardHealth pays a median of $62.87 across its rate types for CPT 99285 in its August 2026 fee-for-service schedule: the lowest of 42 state Medicaid programs, at 45% of the $138.69 median.
- Non-facility rate
- $62.87
- Rank
- 42 of 42
- vs. state median
- 45%
- vs. WI Medicare
- 39%
What ForwardHealth publishes for 99285
Lowest of 42 · 45% of median
- Schedule
- August 2026
- In effect since
- Jan 1, 2024
$59.56 to $66.18 across 2 rate types
- Rate type MED · 5 provider specialties · 7 places of service
- $66.18
- Rate type PT1 · 2 provider specialties · 7 places of service
- $59.56
4 rate types
- Rate type MED · 6 provider specialties · Under 19 · 7 places of service · Payment adjustment and 1 more (TJ)
- $66.18
- Rate type MED · 17 provider specialties · Under 19 · 7 places of service · HPSA adjustment and 7 more (AQ)
- $66.18
- Rate type PT1 · 2 provider specialties · Ages 19+ · 7 places of service and 4 more (AQ)
- $59.56
- Rate type PT1 · 2 provider specialties · Ages 19+ · 7 places of service and 1 more (TJ)
- $59.56
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
99285 in neighboring states
Each state's comparable non-facility rate for 99285 in its current schedule.
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 Wisconsin is $159.34; ForwardHealth's rate is 39% of that. The national amount before geographic adjustment is $171.347.
See 99285 Medicare ratesSee Wisconsin's full schedule: all 7,754 codes, every published period, and commercial payer rates for 99285.
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