The Same Office Visit Pays $33 in Florida and $165 in Alaska

99213 is the workhorse code of outpatient medicine: a routine office visit for an established patient, the appointment most of primary care is built on. The visit is the same everywhere. The code is the same everywhere. What Medicaid pays for it is not. Florida reimburses $32.58 for a 99213. Alaska reimburses $165.33. That is a 5x gap for identical work, and the states in between fill nearly every dollar of the range.

Across the 48 states that publish a directly comparable rate for the code, the median is about $74, which works out to 78% of what Medicare pays for the same visit ($95.19 on the 2026 national schedule). But the familiar policy shorthand, that Medicaid pays physicians roughly three-quarters of Medicare, is an average hiding a wild spread. Six states now pay more than Medicare for a 99213: Alaska (174% of the Medicare amount), New Mexico (135%), Montana (131%), North Dakota (110%), Rhode Island (106%), and Nebraska (105%). At the other end, Florida (34%), Texas (36%), Pennsylvania (37%), Michigan (38%), and Arkansas (41%) all pay less than half the Medicare rate.

As with dental rates, the gaps ignore geography. Cross from Pennsylvania ($35.00) into New York ($86.75) and the same visit pays two and a half times more. Cross from Ohio ($46.23) into Indiana ($84.31) and it nearly doubles. A primary care practice on the wrong side of a state line is running a structurally different business than its neighbor twenty minutes away.

Why the spread exists

Medicaid physician fees work the way Medicaid dental fees do: the federal government funds the program in part, but every state sets its own fee schedule, and there is no federal floor under any individual rate. Some legislatures peg their schedule to a percentage of Medicare and update it annually. Others have not revisited their conversion factors in years, which is how a state ends up paying a third of Medicare while its neighbor pays parity. The rural states at the top of the list (Alaska, Montana, North Dakota) are paying above Medicare for the same reason they top the dental rankings: when the nearest alternative provider is a hundred miles away, the rate is the access policy.

Every schedule, every category, one place

Last month this analysis would have required pulling 51 separate state fee schedules in 51 formats. We know because we did it: first for dental rates, and now for everything else. ProviderSignal now carries 2 million+ published Medicaid rates across all 50 states and DC, spanning every service category states publish: physician and surgical services, lab and imaging, durable medical equipment and supplies, drugs, vision, behavioral health, anesthesia, hearing, transport, and LTSS/waiver services. Every rate with a national Medicare comparator is benchmarked against it, which is what makes a ranking like the one above possible to produce in seconds instead of weeks.

Look up your own state

Every number above comes from the states' published fee schedules. You can compare all 48 states on this exact office visit, see every state's physician schedule ranked by percent of Medicare (here is Florida and Alaska), or start from the full category index. The complete all-codes schedules, with CSV export and rate-change tracking, come with the $29/mo Rates plan, because these schedules do change, quietly, and the practices that notice first bill correctly first.

Methodology: rates queried from the ProviderSignal fee-schedule database on August 23, 2026. Per-state figure = the state's published fee-for-service, non-facility rate for CPT 99213 with no modifiers or age restrictions, from its current fee schedule. Medicare comparator = the 2026 national non-facility Physician Fee Schedule amount ($95.19). 48 of 51 jurisdictions publish a directly comparable rate: Tennessee runs medical Medicaid entirely through managed care and publishes no FFS physician schedule, and Maryland and South Dakota do not publish a bare rate for this code in the schedules we collect. These are fee-for-service schedule amounts, not Medicaid managed-care plan rates, and rates shift as states publish updates.