Every state, kept current
The Rates plan
$29/mo7-day free trialThe table on this page is a common-procedure sample. The full District of Columbia state-specific services schedule has 454 codes.
- Every code on all 51 published schedules
- Full-schedule CSV export and state network lists
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Published codes
454
state-specific and temporary HCPCS codes on the 2026 schedule
Median % of Medicare
94.2%
vs national Medicare, GPCI-neutral
PA required
352
+14 conditional or varies
Common state-specific and temporary HCPCS codes 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 Medicaid fee schedule 2026, all categories
- 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
State-Specific Services rates in neighboring states
Frequently asked questions
What does District of Columbia Medicaid pay for state-specific and temporary HCPCS services?
District of Columbia Medicaid publishes 454 state-specific and temporary HCPCS code rates effective 2026, paying a median 94.2% of the national Medicare amount for the same services. The schedule covers clinic and screening encounters, telehealth facility fees, personal care, and other C, Q, S and T 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 state-specific services rates compare with Medicare?
Across state-specific 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 state-specific and temporary HCPCS services need prior authorization in District of Columbia?
District of Columbia publishes prior-authorization flags on its schedule: 352 state-specific 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.