99080 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 7 state Medicaid programs publish a fee-for-service rate for 99080. Rates run from $1.00 in Kansas to $49.61 in Oregon, with a median of $17.42.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 7
- Median rate
- $17.42units vary by state
- Highest
- $49.61Oregon
- Medicare (non-facility)
- —not on the physician fee schedule
99080 rate in every state
One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $49.61since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | OHA Administrative Examinations and Repo |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $27.38since 2023-07-01 | — | — | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $27.08since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service CPT |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $17.42since 2003-06-20 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file cptmedical4.csv |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $10.49since 2025-09-01 | — | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid disability determination exams (Medical Review Team) | $10.00since 2002-07-01 | unit | — | Not classified | — | IHCP Professional Fee Schedule (Last Upd |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $1.00since 1978-07-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.
Frequently asked questions
What does Medicaid pay for 99080?
It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $17.42. Oregon pays the most ($49.61) and Kansas the least ($1.00).
Which state pays the highest Medicaid rate for 99080?
Oregon, at $49.61, effective 2026-01-01.
Do managed-care plans pay the same rate for 99080?
Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The table shows the rule for each state, cited to the contract or statute.