Vermont Medicaid Fee Schedule

Vermont Medicaid, published by the Vermont Department of Vermont Health Access (DVHA). Schedules effective through Aug 2026.

Vermont publishes 11,854 Medicaid fee-for-service rates across 10 service categories. An established-patient office visit (99213) pays $79.37, a CPAP device (E0601) $770.52 and a two-view chest X-ray (71046) $27.74. Pooled across categories with a national Medicare comparator, Vermont's published rates run a median 82.7% of the Medicare amount, ranking 23 of 49 jurisdictions with a comparable basis.

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These pages show common-procedure samples per category. The complete all-codes Vermont schedules export as CSV with the Rates plan.

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Vermont's published schedules by category

Codes on the current schedule, the newest effective date, the median published rate as a percentage of national Medicare where a comparator exists, and one recognizable procedure's rate per category. Open a category for its common-procedure table.

CategoryCodesEffectiveMedian % of MedicareExample ratePA required
Physician6,514Aug 202681.3%$79.37 Office visit, established patient, low complexity (20-29 min) (99213)163
Lab & Imaging1,880Jan 202697.5%$27.74 Chest X-ray, 2 views (71046)71
DME & Supplies1,914Apr 202683.5%$770.52 Continuous positive airway pressure (cpap) device (E0601)113
Drugs746Jul 2026----255
Vision150Jan 202634%$126.19 Eye exam, new patient, comprehensive (92004)4
Behavioral Health44Jul 202684.3%$141.08 Psychotherapy, 60 minutes (90837)1
Anesthesia274Jan 2022------
Hearing37Jan 2026--$900.00 Hearing aid, digital, binaural, bte (V5261)--
Transport24Jul 2026--$270.28 Ambulance service, basic life support, non-emergency transport, (bls) (A0428)--
State-Specific Services271Jul 202683.8%$16.00 Telehealth originating site facility fee (Q3014)41
DentalVermont's dental Medicaid rates live in the dental section, with their own per-state page.

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.

Where Vermont publishes its fee schedules

Publisher
Vermont Department of Vermont Health Access (DVHA)
Program
Vermont Medicaid
Official source
https://www.vtmedicaid.com/#/feeSchedule
Last checked
Aug 21, 2026

ProviderSignal collects every category from the state's publication, standardizes the rows and labels each code in its own plain language. Rates are the published amounts; the state's page remains the legal source.

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These are common-procedure samples. The complete Vermont schedules, every category and every code, export as CSV on the Rates plan.

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Frequently asked questions

Does Vermont publish a Medicaid fee schedule?

Yes. Vermont publishes 11,854 Medicaid fee-for-service procedure rates across 10 service categories, effective through Aug 2026, all collected and normalized here with plain-language procedure names. Vermont Department of Vermont Health Access (DVHA) publishes Vermont's Medicaid fee schedules.

Who publishes Vermont's Medicaid fee schedule?

Vermont Department of Vermont Health Access (DVHA) publishes Vermont's Medicaid fee schedules. The state's own fee-schedule page is https://www.vtmedicaid.com/#/feeSchedule. ProviderSignal collects every category from it, standardizes the rows and re-checks the source on a rolling cadence (last checked Aug 21, 2026).

What does Vermont Medicaid pay for common services?

An established-patient office visit (99213) pays $79.37, a CPAP device (E0601) $770.52 and a two-view chest X-ray (71046) $27.74. Every figure is the state's published fee-for-service amount for the code's benchmark locality; managed-care plans can pay differently. The category pages list common procedures with plain-language names, and the complete all-codes schedules export as CSV on the Rates plan.

How do Vermont's Medicaid rates compare with Medicare?

Pooled across categories with a national Medicare comparator, Vermont's published rates run a median 82.7% of the Medicare amount, ranking 23 of 49 jurisdictions with a comparable basis.

What service categories does Vermont publish?

Physician (6,514 codes), Lab & Imaging (1,880 codes), DME & Supplies (1,914 codes), Drugs (746 codes), Vision (150 codes), Behavioral Health (44 codes), Anesthesia (274 codes), Hearing (37 codes), Transport (24 codes), State-Specific Services (271 codes). Dental rates have their own section with per-state pages.

How current are these rates?

Rates come from Vermont's currently published fee schedules, the newest effective Aug 2026, and are re-collected on a rolling monthly cadence. This page updates automatically after each collection sweep.