S0199 Medicaid reimbursement rates by state
Medically induced abortion by oral ingestion of medication.... 10 state Medicaid programs publish a fee-for-service rate for S0199 at the physician psychologist level. Rates run from $176.39 in Oregon to $690.00 in Pennsylvania, with a median of $412.80.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 10
- Median rate
- $412.80units vary by state
- Highest
- $690.00Pennsylvania
- Medicare (non-facility)
- —not on the physician fee schedule
S0199 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 |
|---|---|---|---|---|---|---|
| PennsylvaniaRegistered nurse (RN) · Pennsylvania Medical Assistance (fee-for-service) | $690.00since 2024-09-09 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $542.93since 2022-09-01 | — | — | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $536.49since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $536.48since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $469.55since 2008-01-01 | — | — | Not classified | — | CMAP fee schedule: Clinic - Family Plann |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $356.04since 2025-07-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $314.85since 2021-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Physician-related services fee sched |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $279.39since 2017-07-01 | — | — | Not classified | — | SCDHHS Physician Assistant/Nurse Practit |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $201.04since 2020-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $176.39since 2010-05-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
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 S0199?
It depends on the state. Of the 10 states with a published fee-for-service rate, the median is $412.80. Pennsylvania pays the most ($690.00) and Oregon the least ($176.39).
Which state pays the highest Medicaid rate for S0199?
Pennsylvania, at $690.00, effective 2024-09-09.
Do managed-care plans pay the same rate for S0199?
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.