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Billing code 99493 · Physician & professional

99493 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $107.08 for 99493 across 33 states, from $53.97 in New Hampshire to $203.76 in Montana.

Data as of Oct 5, 202633 statesEvery rate links to its official source

States publishing
33
National median
$107.08units vary by state
Lowest
$53.97New Hampshire
Highest
$203.76Montana
Answer

What does Medicaid pay for 99493?

33 state Medicaid programs publish a fee-for-service rate for 99493. The national median is $107.08 (units differ between states). Montana pays the most, $203.76, and New Hampshire the least, $53.97, a 3.8x spread.

Medicare (non-facility, 2026 physician fee schedule): $134.93–$182.06 depending on the state's Medicare locality.

State ranking

99493 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 33 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Montana Source · since 2026-07-01$203.76——Not classified—
2District of Columbia Source · since 2025-01-01$167.97——Not classified—
3Nebraska Source · since 2026-07-01$150.03——Plans negotiate; applies out of network—
16Connecticut Source · since 2026-01-01$110.56——Not classified—
17Colorado Source · since 2026-07-01$107.08——Paid by the state, outside plans—
18South Carolina Source · since 2024-10-01$102.16——Not classified—
32Pennsylvania Source · since 2019-08-19$64.36——Plans negotiate; applies out of network—
33New Hampshire Source · since 2023-07-01$53.97——Plans negotiate; applies out of network—
See all 33 states for 99493 — start free

25 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

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Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track 99493 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
FAQ

Frequently asked questions

What does Medicaid pay for 99493?

It depends on the state. Of the 33 states with a published fee-for-service rate, the median is $107.08. Montana pays the most ($203.76) and New Hampshire the least ($53.97).

Which state pays the highest Medicaid rate for 99493?

Montana, at $203.76, effective 2026-07-01.

Do managed-care plans pay the same rate for 99493?

Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The workspace shows the rule for each state, cited to the contract or statute.