Every state, kept current
The Rates plan
$29/mo7-day free trialThe table on this page is a common-procedure sample. The full Kentucky physician schedule has 7,029 codes.
- Every code on all 51 published schedules
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Published codes
7,029
Physician procedures on the 2026 schedule
Median % of Medicare
74.1%
vs national Medicare, GPCI-neutral
PA required
229
codes flagged by the state
Common physician procedures and what Kentucky Medicaid pays
A curated sample of recognizable procedures from the 7,029-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 | Kentucky rate | % of Medicare |
|---|---|---|---|
| 10021 | Fine needle aspiration biopsy, first lesion, no imaging | $65.38 | 64.8% |
| 10060 | Drainage of a skin abscess, simple | $45.64 | 35.5% |
| 10061 | Drainage of a skin abscess, complicated or multiple | $91.40 | 41.5% |
| 10080 | Drainage of a pilonidal cyst, simple | $62.16 | 23.1% |
| 10081 | Drainage of a pilonidal cyst, complicated | $104.08 | 27.4% |
| 10120 | Removal of a foreign body from tissue, simple | $48.47 | 30.8% |
| 10121 | Removal of a foreign body from skin, complicated | $107.20 | 39% |
| 10140 | Drainage of a blood or fluid collection under the skin | $57.52 | 33% |
| 10160 | Needle drainage of an abscess or cyst | $45.15 | 34.3% |
| 10180 | Drainage of an infected surgical wound | $97.09 | 33.7% |
| 11000 | Removal of infected or dead skin, up to 10% of body | $38.40 | 65% |
| 11042 | Wound debridement, skin and tissue below, first 20 sq cm | $48.18 | 36.3% |
| 11043 | Wound debridement to muscle, first 20 sq cm | $110.51 | 46.1% |
| 11044 | Wound debridement to bone, first 20 sq cm | $154.45 | 48.2% |
| 11045 | Wound debridement, skin, each added 20 sq cm | $27.00 | 64.7% |
| 11055 | Trimming of one callus or corn | $14.74 | 21% |
| 11056 | Trimming of 2-4 calluses or corns | $20.76 | 25.6% |
| 11057 | Trimming of 5 or more calluses or corns | $22.12 | 24.9% |
| 11102 | Skin biopsy, tangential, first lesion | $75.29 | 78.8% |
| 11104 | Skin biopsy, punch, first lesion | $94.66 | 78.1% |
| 11106 | Skin biopsy, incisional, first lesion | $114.57 | 75.7% |
| 11200 | Removal of skin tags, up to 15 | $32.75 | 35.5% |
| 11201 | Removal of skin tags, each added 10 | $12.68 | 69% |
| 11300 | Shave removal of a skin lesion, trunk/arm/leg, 0.5 cm or less | $30.40 | 31.5% |
| 11305 | Shave removal of a skin lesion, scalp/neck/genitals, 0.5 cm or less | $34.82 | 34.4% |
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 Kentucky Medicaid fee schedules
- Kentucky Medicaid fee schedule 2026, all categories
- Kentucky lab & imaging fee schedule · 2,645 codes
- Kentucky dme & supplies fee schedule · 1,815 codes
- Kentucky state-specific services fee schedule · 524 codes
- Kentucky drugs fee schedule · 505 codes
- Kentucky vision fee schedule · 152 codes
- Kentucky behavioral health fee schedule · 48 codes
Physician rates in neighboring states
Frequently asked questions
What does Kentucky Medicaid pay for physician and professional services?
Kentucky Medicaid publishes 7,029 physician procedure rates effective 2026, paying a median 74.1% of the national Medicare amount for the same services. The schedule covers office visits, preventive care, surgery, and evaluation and management services. 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 Kentucky's physician rates compare with Medicare?
Across physician codes with a national Medicare comparator, Kentucky Medicaid pays a median 74.1% of the Medicare amount (GPCI-neutral national comparison). Individual codes vary widely, so check the per-code percentage in the table.
Do physician services need prior authorization in Kentucky?
Kentucky publishes prior-authorization flags on its schedule: 229 physician codes are marked as always requiring PA. Codes without a flag carry no published PA indicator.
Where do these rates come from?
Directly from Kentucky'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.