Missouri Medicaid Fee Schedule

MO HealthNet, published by the Missouri Department of Social Services, MO HealthNet Division (DSS). Schedules effective through Jul 2026.

Missouri publishes 12,358 Medicaid fee-for-service rates across 9 service categories. An established-patient office visit (99213) pays $75.21, a two-view chest X-ray (71046) $21.53 and a CPAP device (E0601) $40.18. Pooled across categories with a national Medicare comparator, Missouri's published rates run a median 81.5% of the Medicare amount, ranking 27 of 49 jurisdictions with a comparable basis.

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These pages show common-procedure samples per category. The complete all-codes Missouri schedules export as CSV with the Rates plan.

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Missouri's published schedules by category

Codes on the current schedule, the newest effective date, the median published rate as a percentage of national Medicare where a comparator exists, and one recognizable procedure's rate per category. Open a category for its common-procedure table.

CategoryCodesEffectiveMedian % of MedicareExample ratePA required
Physician6,776Jul 202682.7%$75.21 Office visit, established patient, low complexity (20-29 min) (99213)71
Lab & Imaging2,806Jul 202681.3%$21.53 Chest X-ray, 2 views (71046)629
DME & Supplies1,621Jul 202657.3%$40.18 Continuous positive airway pressure (cpap) device (E0601)202
Vision147Jul 202667.5%$112.23 Eye exam, new patient, comprehensive (92004)97
Behavioral Health61Jul 202689.3%$160.00 Psychotherapy, 60 minutes (90837)2
Anesthesia275Jul 2025----3
Hearing53Jul 2024--$5,000.00 Hearing aid, digital, binaural, bte (V5261)--
Transport16Jan 2026--$105.62 Ambulance service, basic life support, non-emergency transport, (bls) (A0428)--
State-Specific Services603Jul 202664.5%$27.59 Telehealth originating site facility fee (Q3014)11
DentalMissouri's dental Medicaid rates live in the dental section, with their own per-state page.

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.

Where Missouri publishes its fee schedules

Publisher
Missouri Department of Social Services, MO HealthNet Division (DSS)
Program
MO HealthNet
Official source
https://apps.dss.mo.gov/fmsfeeschedules/
Last checked
Aug 21, 2026

ProviderSignal collects every category from the state's publication, standardizes the rows and labels each code in its own plain language. Rates are the published amounts; the state's page remains the legal source.

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These are common-procedure samples. The complete Missouri schedules, every category and every code, export as CSV on the Rates plan.

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Frequently asked questions

Does Missouri publish a Medicaid fee schedule?

Yes. Missouri publishes 12,358 Medicaid fee-for-service procedure rates across 9 service categories, effective through Jul 2026, all collected and normalized here with plain-language procedure names. Missouri Department of Social Services, MO HealthNet Division (DSS) publishes Missouri's Medicaid fee schedules for MO HealthNet.

Who publishes Missouri's Medicaid fee schedule?

Missouri Department of Social Services, MO HealthNet Division (DSS) publishes Missouri's Medicaid fee schedules for MO HealthNet. The state's own fee-schedule page is https://apps.dss.mo.gov/fmsfeeschedules/. ProviderSignal collects every category from it, standardizes the rows and re-checks the source on a rolling cadence (last checked Aug 21, 2026).

What does Missouri Medicaid pay for common services?

An established-patient office visit (99213) pays $75.21, a two-view chest X-ray (71046) $21.53 and a CPAP device (E0601) $40.18. Every figure is the state's published fee-for-service amount for the code's benchmark locality; managed-care plans can pay differently. The category pages list common procedures with plain-language names, and the complete all-codes schedules export as CSV on the Rates plan.

How do Missouri's Medicaid rates compare with Medicare?

Pooled across categories with a national Medicare comparator, Missouri's published rates run a median 81.5% of the Medicare amount, ranking 27 of 49 jurisdictions with a comparable basis.

What service categories does Missouri publish?

Physician (6,776 codes), Lab & Imaging (2,806 codes), DME & Supplies (1,621 codes), Vision (147 codes), Behavioral Health (61 codes), Anesthesia (275 codes), Hearing (53 codes), Transport (16 codes), State-Specific Services (603 codes). Dental rates have their own section with per-state pages.

How current are these rates?

Rates come from Missouri's currently published fee schedules, the newest effective Jul 2026, and are re-collected on a rolling monthly cadence. This page updates automatically after each collection sweep.