99601 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 8 state Medicaid programs publish a fee-for-service rate for 99601. Rates run from $35.00 in Pennsylvania to $90.00 in Kentucky, with a median of $75.59.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 8
- Median rate
- $75.59units vary by state
- Highest
- $90.00Kentucky
- Medicare (non-facility)
- —not on the physician fee schedule
99601 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 |
|---|---|---|---|---|---|---|
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $90.00since 2022-01-01 | — | — | State sets the plan rate | — | KY Medicaid DME fee schedule (2022Medica |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $90.00since 2004-01-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $86.99since 2026-03-01 | — | — | Plans negotiate; applies out of network | — | Rates for Durable Medical Equipment, Oxy |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $83.71since 2025-07-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $67.47since 2023-10-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Home Health Fee Schedule database, |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $47.69since 2011-08-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $40.00since 2018-08-10 | percent of billed charges | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $35.00since 2005-11-01 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
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 99601?
It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $75.59. Kentucky pays the most ($90.00) and Pennsylvania the least ($35.00).
Which state pays the highest Medicaid rate for 99601?
Kentucky, at $90.00, effective 2022-01-01.
Do managed-care plans pay the same rate for 99601?
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.