99501 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 7 state Medicaid programs publish a fee-for-service rate for 99501. Rates run from $17.31 in South Dakota to $137.61 in Missouri, with a median of $58.29.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 7
- Median rate
- $58.29units vary by state
- Highest
- $137.61Missouri
- Medicare (non-facility)
- —not on the physician fee schedule
99501 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 |
|---|---|---|---|---|---|---|
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $137.61since 2024-07-01 | — | — | Plans negotiate; applies out of network | — | MO HealthNet fee schedule: Home Health |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $88.00since 2005-10-01 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $68.00since 2021-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, June 202 |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $58.29since 2025-10-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Local Health D |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service) | $49.13since 2024-07-01 | — | — | Plans negotiate; applies out of network | — | RI Medicaid Interactive Fee For Service |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $43.80since 2023-07-01 | — | — | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $17.31since 2026-07-01 | — | — | Not classified | — | South Dakota Medicaid Physician fee sche |
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 99501?
It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $58.29. Missouri pays the most ($137.61) and South Dakota the least ($17.31).
Which state pays the highest Medicaid rate for 99501?
Missouri, at $137.61, effective 2024-07-01.
Do managed-care plans pay the same rate for 99501?
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.