G0313 Medicaid Rate by State

Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 16-30 mins time (this code is used for medicaid billing purposes)

22 state Medicaid programs publish a fee-for-service rate for G0313 (immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 16-30 mins time (this code is used for medicaid billing purposes)), ranging from $13.00 in Alabama to $147.78 in Idaho.

Every state, kept current

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This page shows one representative rate per state for G0313. Full schedules include every locality, modifier, and age-band variant.

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Publishing states

22

Median % of Medicare

--

Rate range

$13.00 - $147.78

G0313 rates in every publishing state

StateMedicaid rate% of MedicarePrior authVintage
Alaska$18.39----2026
Alabama$13.00----2026
Arizona$58.24----2022
Delaware$44.20----2026
Hawaii$24.13----2025
Iowa$29.84----2024
Idaho$147.78--Not required2025
Indiana$56.72----2025
Kansas$20.00----2023
Massachusetts$47.16----2026
Maine$26.90----2026
Missouri$50.75--Not required2021
Mississippi$54.34----2026
North Dakota$71.30--Not required2026
Nebraska$55.06----2026
New Hampshire$30.65--Not required2026
New Jersey$19.38--Not required2026
New Mexico$29.06----2025
Nevada$50.18----2024
Ohio$39.90----2022
Utah$46.05*--Not required2023
Wisconsin$33.26----2023

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 G0313?

22 state Medicaid programs publish a fee-for-service rate for G0313 (immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 16-30 mins time (this code is used for medicaid billing purposes)), ranging from $13.00 in Alabama to $147.78 in Idaho. The full table on this page lists every publishing state's current rate.

Which state pays the most for G0313?

Idaho publishes the highest Medicaid rate for G0313 at $147.78. Alabama publishes the lowest at $13.00.

Does G0313 require prior authorization under Medicaid?

No publishing state flags G0313 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.