The Rates plan
$29/mo7-day free trialThe table on this page is a common-procedure sample. The full District of Columbia other services schedule has 454 codes.
- Every code on all 51 published schedules
- Full-schedule CSV export
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Published codes
454
Other Services procedures on the 2026 schedule
Median % of Medicare
94.2%
vs national Medicare, GPCI-neutral
PA required
352
+14 conditional or varies
Common other services procedures and what District of Columbia Medicaid pays
A curated sample of recognizable procedures from the 454-code schedule. Rates are the state's published fee-for-service amounts; the percentage compares each rate with the national Medicare amount for the same code.
| Code | Procedure | District of Columbia rate | % of Medicare |
|---|---|---|---|
| S5125 | Attendant care services; per 15 minutes | $4.08* | -- |
| T1015 | Clinic visit/encounter, all-inclusive | $51.00* | -- |
| T1019 | Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant) | $7.69* | -- |
| T2021 | Day habilitation, waiver; per 15 minutes | $5.35* | -- |
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 * show the schedule's representative published variant.
More District of Columbia Medicaid fee schedules
- District of Columbia physician fee schedule · 6,530 codes
- District of Columbia lab & imaging fee schedule · 1,998 codes
- District of Columbia dme & supplies fee schedule · 1,711 codes
- District of Columbia drugs fee schedule · 868 codes
- District of Columbia vision fee schedule · 160 codes
- District of Columbia behavioral health fee schedule · 68 codes
Other Services rates in neighboring states
Frequently asked questions
What does District of Columbia Medicaid pay for other covered services?
District of Columbia Medicaid publishes 454 other services procedure rates effective 2026, paying a median 94.2% of the national Medicare amount for the same services. The schedule covers clinic encounters, screenings, and state-specific service codes. The table on this page shows published rates for common procedures; the complete all-codes schedule is available as a CSV download with a ProviderSignal Rates subscription.
How do District of Columbia's other services rates compare with Medicare?
Across other services codes with a national Medicare comparator, District of Columbia Medicaid pays a median 94.2% of the Medicare amount (GPCI-neutral national comparison). Individual codes vary widely, so check the per-code percentage in the table.
Do other services services need prior authorization in District of Columbia?
District of Columbia publishes prior-authorization flags on its schedule: 352 other services codes are marked as always requiring PA. Codes without a flag carry no published PA indicator.
Where do these rates come from?
Directly from District of Columbia's published Medicaid fee-for-service schedule (effective 2026), collected and normalized by ProviderSignal across all 50 states + DC. Rates are re-collected on a rolling schedule and this page updates automatically. Procedure descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.
Get an email the next time District of Columbia changes these rates.