Missouri Medicaid State-Specific Services Fee Schedule 2026

Missouri Medicaid publishes 603 state-specific and temporary HCPCS code rates effective 2026, paying a median 64.5% of the national Medicare amount for the same services. This page lists the Q, S, T and C codes Missouri prices outside its standard categories, with plain-language descriptions and, where a comparator exists, each rate as a percentage of national Medicare. It is one category of the Missouri Medicaid fee schedule (9 categories).

Every state, kept current

The Rates plan

$29/mo7-day free trial

The table on this page is a common-procedure sample. The full Missouri state-specific services schedule has 603 codes.

  • Every code on all 51 published schedules
  • Full-schedule CSV export and state network lists
  • Email alerts when a state changes its rates
Start free trial

$29/mo after the trial. Cancel anytime.

Published codes

603

state-specific and temporary HCPCS codes on the 2026 schedule

Median % of Medicare

64.5%

vs national Medicare, GPCI-neutral

PA required

11

+51 conditional or varies

Common state-specific and temporary HCPCS codes and what Missouri Medicaid pays

A curated sample of recognizable procedures from the 603-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.

CodeProcedureMissouri rate% of Medicare
S5125Attendant care services; per 15 minutes$10.88*--
T1015Clinic visit/encounter, all-inclusive$40.60--
T1019Personal 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)$10.13--
T2021Day habilitation, waiver; per 15 minutes$12.41--

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 Missouri Medicaid fee schedules

State-Specific Services rates in neighboring states

Frequently asked questions

What does Missouri Medicaid pay for state-specific and temporary HCPCS services?

Missouri Medicaid publishes 603 state-specific and temporary HCPCS code rates effective 2026, paying a median 64.5% 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 Missouri's state-specific services rates compare with Medicare?

Across state-specific services codes with a national Medicare comparator, Missouri Medicaid pays a median 64.5% 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 Missouri?

Missouri publishes prior-authorization flags on its schedule: 11 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 Missouri'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.