The Rates plan
$29/mo7-day free trialThese pages show common-procedure samples per category. The complete all-codes Pennsylvania schedules export as CSV with the Rates plan.
- Every code on all 51 published schedules
- Full-schedule CSV export
- Full state Medicaid dental network lists
- Email alerts when a state changes its rates
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How Pennsylvania pays
Pennsylvania publishes facility schedules (including inpatient rate files) alongside its professional fee schedule. Facility-grain rows keep their published rates but are excluded from Medicare-percentage comparisons.
Pennsylvania's published schedules by category
Physician
4,676codes
See the schedule →
Lab & Imaging
1,500codes
See the schedule →
DME & Supplies
1,408codes
See the schedule →
Other Services
62codes
See the schedule →
Vision
40codes
See the schedule →
Behavioral Health
26codes
See the schedule →
Hearing
24codes
See the schedule →
Transport
4codes
See the schedule →
Drugs
1codes
See the schedule →
Dental
Pennsylvania's dental Medicaid rates live in the dental section.
See dental rates →
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.
Compare Pennsylvania nationally
Frequently asked questions
Does Pennsylvania publish a Medicaid fee schedule?
Yes. Pennsylvania publishes 7,741 Medicaid fee-for-service procedure rates across 9 service categories, all collected and normalized here with plain-language procedure names. One thing to know about how Pennsylvania pays: Pennsylvania publishes facility schedules (including inpatient rate files) alongside its professional fee schedule. Facility-grain rows keep their published rates but are excluded from Medicare-percentage comparisons.
How do Pennsylvania's Medicaid rates compare with Medicare?
Pooled across categories with a national Medicare comparator, Pennsylvania's published rates run a median 55.5% of the Medicare amount, ranking 48 of 49 jurisdictions with a comparable basis.
What service categories does Pennsylvania publish?
Physician (4,676 codes), Lab & Imaging (1,500 codes), DME & Supplies (1,408 codes), Other Services (62 codes), Vision (40 codes), Behavioral Health (26 codes), Hearing (24 codes), Transport (4 codes), Drugs (1 codes). Dental rates have their own section with per-state pages.
How current are these rates?
Rates come from Pennsylvania's currently published fee schedules and are re-collected on a rolling monthly cadence, so most schedules here are effective 2026. This page updates automatically after each collection sweep.