Physician codes 99000 to 99607 with Medicaid rates by state

178 physician codes from 99000 to 99607 carry a published Medicaid rate in ten or more states. The median shown is across those states' unmodified published rates; open a code for the full state-by-state table with percent of Medicare and prior-authorization flags.

CodeDescriptionStatesMedian rate
99000Specimen handling, office to lab16$3.85
99001Specimen handling, patient location to lab14$3.90
99050Services after posted office hours25$13.22
99051Services during scheduled evening, weekend or holiday hours15$11.49
99058Office services on an emergency basis15$17.73
99070Supplies and materials provided by the office13$13.44
99082Unusual travel by physician15$5.60
99091Physiologic data collection and review, 30 days20$45.84
99100Anesthesia for extreme age, under 1 or over 70 (add-on)10$17.95
99140Anesthesia under emergency conditions (add-on)10$25.63
99151Moderate sedation by same provider, first 15 min, under 545$53.31
99152Moderate sedation by same provider, first 15 min, age 5+47$41.72
99153Moderate sedation by same provider, each added 15 minutes47$9.56
99155Moderate sedation by separate provider, 15 min, under 545$70.60
99156Moderate sedation by separate provider, 15 min, age 5+45$61.10
99157Moderate sedation by separate provider, each added 15 min45$46.74
99170Magnified anogenital exam of a child for suspected abuse41$126.73
99172Visual function screening, automated13$15.64
99173Vision screening test, quantitative36$3.88
99174Instrument-based vision screening25$6.08
99175Ipecac given to induce vomiting36$35.71
99177Instrument-based vision screening, both eyes29$4.44
99183Hyperbaric oxygen therapy supervision, per session47$99.49
99184Cooling treatment for newborn brain injury36$180.93
99188Fluoride varnish applied by a physician39$18.38
99195Therapeutic blood removal (phlebotomy)48$76.09
99202Office visit, new patient, straightforward (15-29 min)49$59.88
99203Office visit, new patient, low complexity (30-44 min)49$92.38
99204Office visit, new patient, moderate complexity (45-59 min)49$138.85
99205Office visit, new patient, high complexity (60-74 min)49$183.88
99211Office visit, established patient, minimal (may not need physician)49$19.59
99212Office visit, established patient, straightforward (10-19 min)49$46.37
99213Office visit, established patient, low complexity (20-29 min)49$75.19
99214Office visit, established patient, moderate complexity (30-39 min)49$107.27
99215Office visit, established patient, high complexity (40-54 min)49$149.36
99221Hospital admission, initial care, low complexity47$66.30
99222Hospital admission, initial care, moderate complexity47$103.31
99223Hospital admission, initial care, high complexity47$141.29
99231Hospital follow-up visit, stable patient47$36.13
99232Hospital follow-up visit, moderate complexity47$58.39
99233Hospital follow-up visit, high complexity47$87.76
99234Same-day hospital admission and discharge, low complexity46$84.68
99235Same-day hospital admission and discharge, moderate46$135.64
99236Same-day hospital admission and discharge, high complexity46$172.93
99238Hospital discharge management, 30 minutes or less47$61.54
99239Hospital discharge management, more than 30 minutes46$87.59
99242Office consultation, straightforward34$67.12
99243Office consultation, low complexity35$94.75
99244Office consultation, moderate complexity34$129.68
99245Office consultation, high complexity35$179.23
99252Inpatient consultation, straightforward32$60.00
99253Inpatient consultation, low complexity32$78.42
99254Inpatient consultation, moderate complexity31$107.27
99255Inpatient consultation, high complexity31$142.67
99281ER visit, minimal (may not need physician)48$11.64
99282ER visit, low urgency49$32.92
99283ER visit, moderate complexity49$55.46
99284ER visit, high complexity without immediate threat49$95.28
99285ER visit, high complexity with significant threat49$138.51
99288Physician direction of emergency medical services12$40.42
99291Critical care, first 30-74 minutes48$231.34
99292Critical care, each added 30 minutes46$102.31
99304Nursing facility admission, low complexity46$66.63
99305Nursing facility admission, moderate complexity47$108.39
99306Nursing facility admission, high complexity47$148.56
99307Nursing facility follow-up, straightforward47$34.10
99308Nursing facility follow-up, low complexity47$61.01
99309Nursing facility follow-up, moderate complexity47$88.33
99310Nursing facility follow-up, high complexity47$125.76
99315Nursing facility discharge, 30 minutes or less40$66.76
99316Nursing home discharge management, over 30 minutes40$106.53
99341Home visit, new patient, straightforward47$44.89
99342Home visit, new patient, low complexity47$69.13
99344Home visit, new patient, moderate complexity46$131.72
99345Home visit, new patient, high complexity46$178.34
99347Home visit, established patient, straightforward47$40.24
99348Home visit, established patient, low complexity47$65.98
99349Home visit, established patient, moderate complexity47$105.68
99350Home visit, established patient, high complexity46$155.20
99358Prolonged service without direct patient contact, first hour18$87.35
99360Physician standby service, each 30 minutes27$49.00
99366Team conference with patient, nonphysician professional21$36.71
99367Medical team conference by physician, patient not present21$45.00
99368Team conference without patient, nonphysician professional19$25.93
99374Home health care plan oversight, 15-29 minutes12$57.08
99377Hospice care plan oversight, 15-29 minutes12$52.60
99379Nursing facility care plan oversight, 15-29 minutes10$54.46
99380Nursing facility care plan oversight, 30 minutes or more10$81.84
99381Preventive visit, new patient, under 1 year47$86.82
99382Preventive visit, new patient, age 1-447$90.86
99383Preventive visit, new patient, age 5-1147$92.91
99384Preventive visit, new patient, age 12-1747$106.28
99385Preventive visit, new patient, age 18-3947$103.30
99386Preventive visit, new patient, age 40-6445$121.05
99387Preventive visit, new patient, age 65+43$129.49
99391Preventive visit, established patient, under 1 year47$79.04
99392Preventive visit, established patient, age 1-447$83.86
99393Preventive visit, established patient, age 5-1147$83.67
99394Preventive visit, established patient, age 12-1747$92.22
99395Preventive visit, established patient, age 18-3947$94.56
99396Preventive visit, established patient, age 40-6445$101.35
99397Preventive visit, established patient, age 65+43$107.30
99401Preventive counseling, 15 minutes40$30.91
99402Preventive counseling, 30 minutes34$50.38
99403Preventive counseling, individual, 45 minutes29$66.36
99404Preventive counseling, individual, 60 minutes28$84.83
99406Tobacco cessation counseling, 3-10 minutes44$12.37
99407Tobacco cessation counseling, over 10 minutes47$23.89
99408Alcohol or substance misuse screening and brief intervention, 15-30 min34$30.44
99409Alcohol or drug screening and intervention, over 30 min30$58.60
99411Preventive counseling, group, 30 minutes16$16.00
99412Preventive counseling, group, 60 minutes16$19.89
99415Prolonged clinical staff service, first hour28$16.62
99416Prolonged clinical staff service, each added 30 minutes28$8.17
99417Prolonged outpatient visit time, each added 15 minutes31$28.76
99418Prolonged inpatient or observation service, each 15 min32$31.24
99421Online digital visit, physician, 5-10 minutes23$12.32
99422Online digital visit, physician, 11-20 minutes23$24.19
99423Online digital visit, physician, 21 minutes or more23$38.79
99424Principal care management, physician, first 30 minutes21$69.29
99425Principal care management, physician, added 30 minutes20$49.48
99426Principal care management, clinical staff, first 30 min23$53.65
99427Principal care management, clinical staff, added 30 min20$42.22
99437Chronic care management, physician, added 30 min (add-on)17$49.75
99439Chronic care management, each added 20 minutes per month22$35.62
99441Telephone evaluation by physician, 5-10 minutes5$42.58
99442Telephone evaluation by physician, 11-20 minutes6$60.10
99443Telephone evaluation by physician, 21-30 minutes6$85.22
99446Specialist phone or online consult to physician, 5-10 min23$14.53
99447Specialist phone or online consult to physician, 11-20 min23$28.86
99448Specialist phone or online consult to physician, 21-30 min23$43.32
99449Specialist phone or online consult to physician, 31+ min22$57.91
99451Specialist written consult to physician, 5 minutes or more33$29.59
99452Referring physician time for specialist consult, 30 min30$29.09
99453Remote monitoring setup and patient education29$16.99
99454Remote monitoring device supply, per 30 days30$41.72
99457Remote monitoring treatment management, first 20 minutes per month29$40.93
99458Remote monitoring treatment management, each added 20 minutes27$34.08
99459Pelvic exam with chaperone (add-on)34$17.14
99460Initial hospital care, normal newborn48$69.68
99461Initial newborn care outside a hospital, per day46$74.75
99462Follow-up hospital care, normal newborn, per day46$32.63
99463Newborn care, admitted and discharged same day48$87.62
99464Attendance at delivery and newborn stabilization46$62.25
99465Newborn resuscitation in the delivery room48$122.44
99466Critical care transport, child, first 30-74 minutes36$193.50
99467Critical care transport, child, each added 30 minutes36$96.62
99468Newborn critical care, first day46$758.07
99469Newborn critical care, each later day46$331.02
99471Infant critical care, first day (29 days to 24 months)46$658.63
99472Infant critical care, later day (29 days to 24 months)46$340.95
99473Home blood pressure monitoring, patient training30$10.94
99474Home blood pressure monitoring, data review, 30 days27$13.10
99475Child critical care, first day (age 2 to 5)46$455.93
99476Child critical care, later day (age 2 to 5)46$271.31
99477Newborn intensive (not critical) care, first day46$284.78
99478Intensive care for a recovering infant under 1500 g, per day46$114.96
99479Intensive care, recovering infant 1500 to 2500 g, per day46$103.62
99480Intensive care, recovering infant 2501 to 5000 g, per day46$98.64
99483Cognitive assessment and care plan28$214.27
99484Behavioral health care management, per month21$41.18
99485Remote supervision of child transport, first 30 minutes14$57.19
99486Remote supervision of child transport, added 30 minutes14$49.72
99487Complex chronic care management, first 60 minutes per month12$112.78
99489Complex chronic care management, each added 30 minutes11$59.35
99490Chronic care management, first 20 minutes per month25$48.28
99491Chronic care management, physician, first 30 minutes16$67.74
99492Psychiatric collaborative care, initial month33$129.52
99493Psychiatric collaborative care, subsequent month32$114.86
99494Psychiatric collaborative care, each added 30 minutes32$50.81
99495Transitional care management, moderate complexity, 14-day contact23$172.08
99496Transitional care management, high complexity, 7-day contact23$236.08
99497Advance care planning discussion, first 30 minutes26$69.66
99498Advance care planning, each added 30 minutes25$63.09
99499Unlisted evaluation and management service12$21.47
99605Pharmacist medication review, new patient, 15 minutes13$47.73
99606Pharmacist medication review, established, 15 minutes14$31.62
99607Pharmacist medication review, each added 15 minutes11$25.80

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. Descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.