The Rates plan
$29/mo7-day free trialTennessee's state-set LTSS / waiver rates are included in the corpus. Medical categories are MCO-negotiated and unpublished, in Tennessee and nowhere else among the 51 jurisdictions we cover.
- 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
$29/mo after the trial. Cancel anytime.
Why there is no TennCare fee schedule
TennCare moved Tennessee's entire Medicaid program into managed care in 1994, the first state to do it wholesale. Three decades later that architecture is complete: members are enrolled with a managed-care organization (BlueCare Tennessee, UnitedHealthcare Community Plan of Tennessee, or Wellpoint Tennessee, formerly Amerigroup, plus the BlueCare-administered TennCare Select plan for defined special populations), the state pays each MCO a capitated amount per member, and the MCO negotiates what it pays every provider in its network.
Those negotiated rates live in private contracts. There is no state-published amount for an office visit, a filling, a lab panel, or a wheelchair, because the state does not set one. When a rate aggregator shows a blank for Tennessee, this is why; when a website claims to list "the TennCare fee schedule" for medical services, it is showing something else.
For a provider or biller, the practical consequences: your rate is in your MCO contract and provider portal, not on a state website; different MCOs can pay differently for the same code; and the closest public window into what MCOs actually pay is hospital price-transparency files, which federally must list payer-specific negotiated rates, Medicaid plans included.
What Tennessee does set
The exception is state-administered long-term services and supports: the DDA waiver schedule behind programs like CHOICES and Employment and Community First. Tennessee sets and publishes those rates itself, and all 55 state-set codes are in the ProviderSignal corpus. It is one waiver schedule, not a set of medical fee schedules; the corpus sorts its codes by code type, which is what the category pages below show.
State-set DDA waiver schedule
55published codes
By code type: ltss / waiver (28), other services (22), behavioral health (3), dme & supplies (1), physician (1).
SB334: the bill that could change this
Senate Bill 334 (Senate sponsor Crowe, with House companion HB372), the proposed Tennessee Medicaid Modernization and Access Act of 2025, would require TennCare reimbursement for four service lines, obstetrics/gynecology, primary care, outpatient mental health, and substance-use-disorder treatment, to match the Medicare fee schedule or average commercial rates, whichever is higher. As of August 2026 it remains an introduced bill in the 2025-26 General Assembly, not law.
If it passes, those categories would gain a statutory rate floor pegged to published benchmarks, which makes them computable per code even without a state-published table. That is the same situation as Oregon, where the state publishes a pricing formula instead of a schedule and ProviderSignal derives the per-code rates. We check the bill's status each quarterly refresh and will publish derived TennCare rates if it becomes law.
Frequently asked questions
Does Tennessee Medicaid have a fee schedule?
No, and that is not missing data. TennCare pays for virtually all medical care through managed-care organizations, so there is no published state fee-for-service schedule for physician, dental, lab, DME, or other medical services. Each MCO negotiates its own provider rates in contracts that are not public. The only rates Tennessee itself sets and publishes are for state-administered long-term services and supports, such as DDA waiver services.
How much does TennCare pay for an office visit?
There is no single answer, because there is no state rate. Payment depends on the contract between the provider and the member's MCO (BlueCare Tennessee, UnitedHealthcare Community Plan, or Wellpoint Tennessee), and those negotiated amounts are not published. Providers can find their rates in their MCO contract or provider portal; the closest public window into MCO-negotiated amounts is hospital price-transparency files, which list payer-specific negotiated rates.
What Medicaid rates does Tennessee publish?
One state-set schedule: the DDA waiver rates behind long-term services and supports programs like CHOICES and Employment and Community First. ProviderSignal carries every state-set Tennessee code, sorted by code type across the Tennessee category pages. Everything else runs through managed care and is not published.
What is Tennessee SB334?
Senate Bill 334 (with House companion HB372), the proposed Tennessee Medicaid Modernization and Access Act of 2025, would require TennCare reimbursement for obstetrics/gynecology, primary care, outpatient mental health, and substance-use-disorder treatment to match the Medicare fee schedule or average commercial rates, whichever is higher. As of August 2026 it is an introduced bill, not law. If enacted, those categories would become computable from published benchmarks, the way ProviderSignal already derives Oregon's rates.