G0245 Medicaid Rate by State

Initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) which must include: (1) the diagnosis of lops, (2) a patient history, (3) a physical examination that consists of at least the following elements: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of a protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear and (4) patient education

15 state Medicaid programs publish a fee-for-service rate for G0245 (initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) which must include: (1) the diagnosis of lops, (2) a patient history, (3) a physical examination that consists of at least the following elements: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of a protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear and (4) patient education), ranging from $26.14 in Illinois to $87.14 in Montana, with a median of 81% of the national Medicare amount.

Every state, kept current

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Publishing states

15

Median % of Medicare

81%

Rate range

$26.14 - $87.14

G0245 rates in every publishing state

StateMedicaid rate% of MedicarePrior authVintage
Arizona$71.11108.6%--2024
Colorado$48.2773.7%--2026
Florida$50.9277.8%--2026
Hawaii$39.9861.1%--2025
Illinois$26.1439.9%--2024
Louisiana$55.4284.7%--2026
Michigan$71.14----2026
Montana$87.14133.1%--2026
New Mexico$57.92----2026
Oregon$53.01*81%--2026
Rhode Island$80.36----2026
Utah$47.35*--Not required2011
Vermont$54.8983.9%--2026
West Virginia$44.4167.8%--2026
Wyoming$55.6084.9%--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

All 136 codes from G0008 to G0659 or every physician code by number.

Frequently asked questions

How much does Medicaid pay for G0245?

15 state Medicaid programs publish a fee-for-service rate for G0245 (initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) which must include: (1) the diagnosis of lops, (2) a patient history, (3) a physical examination that consists of at least the following elements: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of a protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear and (4) patient education), ranging from $26.14 in Illinois to $87.14 in Montana, with a median of 81% of the national Medicare amount. The full table on this page lists every publishing state's current rate.

Which state pays the most for G0245?

Montana publishes the highest Medicaid rate for G0245 at $87.14 (133.1% of the national Medicare amount). Illinois publishes the lowest at $26.14.

Does G0245 require prior authorization under Medicaid?

No publishing state flags G0245 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.