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T2005 Medicaid reimbursement rates by state

Emergency department APG base rate. 8 state Medicaid programs publish a fee-for-service rate for T2005. Rates run from $1.00 in Virginia to $172.00 in New York, with a median of $43.80.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
8
Median rate
$43.80units vary by state
Highest
$172.00New York
Medicare (non-facility)
—not on the physician fee schedule

T2005 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.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid transportation (fee-for-service, via the state transportation broker)$172.00⚠ over 3× mediansince 2024-08-01——Paid by the state, outside plans—eMedNY NYS Medicaid Transportation Fee S
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$60.00since 2005-08-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$49.09since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Ground Non-Emergency Medical
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$47.06since 2021-07-01——Not classified—Health First Colorado Physician Fee Sche
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$40.53since 2022-01-01——Paid by the state, outside plans—ForwardHealth max fee schedule: Transpor
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$26.29since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$11.64since 2023-01-01——Plans negotiate; applies out of network—HFS Transportation Fee Schedule (effecti
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$1.00since 2008-04-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv

Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 T2005?

It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $43.80. New York pays the most ($172.00) and Virginia the least ($1.00).

Which state pays the highest Medicaid rate for T2005?

New York, at $172.00, effective 2024-08-01.

Do managed-care plans pay the same rate for T2005?

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.

Related Hospital outpatient codes

Track T2005 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
Medicaid rates by state