99393 Medicaid Rate by State

Preventive visit, established patient, age 5-11

47 state Medicaid programs publish a fee-for-service rate for 99393 (preventive visit, established patient, age 5-11), ranging from $20.00 in Pennsylvania to $183.49 in Alaska.

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This page shows one representative rate per state for 99393. Full schedules include every locality, modifier, and age-band variant.

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Publishing states

47

Median % of Medicare

--

Rate range

$20.00 - $183.49

99393 rates in every publishing state

StateMedicaid rate% of MedicarePrior authVintage
Alaska$183.49----2026
Alabama$88.00*----2026
Arkansas$61.01----2026
Arizona$94.40----2024
California$115.85----2026
Colorado$93.13----2026
Connecticut$70.34----2026
District of Columbia$97.19--Not required2026
Delaware$105.70----2026
Florida$52.01----2026
Georgia$106.58*----2026
Hawaii$73.80----2025
Iowa$69.12----2024
Idaho$98.50--Not required2025
Illinois$31.28----2026
Indiana$96.74----2025
Kansas$27.25----2024
Kentucky$78.58----2026
Louisiana$83.08----2026
Massachusetts$82.86----2026
Maine$58.37----2010
Michigan$53.49----2026
Minnesota$85.01----2026
Missouri$24.20--Not required2022
Mississippi$100.10----2026
Montana$142.04----2026
North Carolina$73.81----2025
North Dakota$120.16--Not required2026
Nebraska$120.58*----2026
New Hampshire$67.95--Not required2026
New Jersey$85.33--Not required2026
New Mexico$147.09----2025
Nevada$109.25----2024
New York$91.13----2026
Ohio$59.67----2024
Oklahoma$95.48----2026
Pennsylvania$20.00----2023
Rhode Island$101.35----2026
South Carolina$84.25----2024
Texas$89.80*----2023
Utah$82.37*--Not required2026
Virginia$78.30*----2026
Vermont$90.83----2026
Washington$74.89----2026
Wisconsin$69.90----2024
West Virginia$73.93----2026
Wyoming$86.97*----2026

Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * are representative published variants or methodology-derived rates. "--" in the prior-auth column means the state publishes no PA flag.

Related physician codes

Frequently asked questions

How much does Medicaid pay for 99393?

47 state Medicaid programs publish a fee-for-service rate for 99393 (preventive visit, established patient, age 5-11), ranging from $20.00 in Pennsylvania to $183.49 in Alaska. The full table on this page lists every publishing state's current rate.

Which state pays the most for 99393?

Alaska publishes the highest Medicaid rate for 99393 at $183.49. Pennsylvania publishes the lowest at $20.00.

Does 99393 require prior authorization under Medicaid?

No publishing state flags 99393 with a prior-authorization indicator on its fee schedule. Absence of a flag means the state publishes none, not that PA is never required - confirm through the state's provider manual.