West Virginia Medicaid reimbursement rates
88,707 current fee-for-service and managed-care rates from West Virginia Medicaid, across 108 services and 6 programs, normalized by code, provider level and unit. Each links to one of 62 official source documents.
Last retrieved 2026-10-05. History back to 2017-01-01.
- Current rates
- 88,707
- Services
- 108
- Programs
- 6
- Lines with a plan rule
- 10of 21 service lines
By industry
Applied behavior analysis (ABA)West Virginia rates, labor costs and changesBehavioral healthWest Virginia rates, labor costs and changesHome healthWest Virginia rates, labor costs and changesHome care & personal careWest Virginia rates, labor costs and changesPrivate duty nursingWest Virginia rates, labor costs and changesSkilled nursing facilitiesWest Virginia rates, labor costs and changesHospiceWest Virginia rates, labor costs and changesIntellectual & developmental disabilitiesWest Virginia rates, labor costs and changesOutpatient therapy (PT, OT, speech)West Virginia rates, labor costs and changes
West Virginia rates by service
The median current rate for each service, like-for-like by unit. Follow a service to compare it with every other state.
Most-compared billing codes in West Virginia
Where West Virginia ranks among states for codes published widely. Rank 1 = highest rate.
| Code | Service | West Virginia | All-state median | Rank |
|---|---|---|---|---|
| 10005 | Physician and practitioner services (fee schedule) | $90.04 | $83.72 | 19 of 45 |
| 10006 | Physician and practitioner services (fee schedule) | $42.46 | $45.25 | 28 of 45 |
| 10007 | Physician and practitioner services (fee schedule) | $227.16 | $180.37 | 17 of 45 |
| 10008 | Physician and practitioner services (fee schedule) | $94.92 | $83.93 | 21 of 45 |
| 10009 | Physician and practitioner services (fee schedule) | $271.08 | $263.06 | 22 of 45 |
| 10010 | Physician and practitioner services (fee schedule) | $156.65 | $139.41 | 21 of 45 |
| 10021 | Physician and practitioner services (fee schedule) | $68.56 | $68.56 | 23 of 45 |
| 10030 | Physician and practitioner services (fee schedule) | $406.26 | $326.39 | 20 of 45 |
| 10060 | Physician and practitioner services (fee schedule) | $86.86 | $87.02 | 24 of 45 |
| 10061 | Physician and practitioner services (fee schedule) | $150.55 | $150.46 | 22 of 45 |
| 10080 | Physician and practitioner services (fee schedule) | $177.14 | $115.26 | 17 of 45 |
| 10081 | Physician and practitioner services (fee schedule) | $254.49 | $187.27 | 16 of 45 |
| 10120 | Physician and practitioner services (fee schedule) | $105.16 | $96.39 | 20 of 45 |
| 10121 | Physician and practitioner services (fee schedule) | $187.15 | $165.54 | 18 of 45 |
| 10140 | Physician and practitioner services (fee schedule) | $117.85 | $106.13 | 18 of 45 |
| 10160 | Physician and practitioner services (fee schedule) | $89.06 | $83.69 | 19 of 45 |
| 10180 | Physician and practitioner services (fee schedule) | $196.18 | $165.58 | 16 of 45 |
| 11000 | Physician and practitioner services (fee schedule) | $39.77 | $36.55 | 18 of 45 |
| 11001 | Physician and practitioner services (fee schedule) | $18.30 | $16.93 | 21 of 45 |
| 11004 | Physician and practitioner services (fee schedule) | $377.96 | $436.33 | 33 of 45 |
| 11005 | Physician and practitioner services (fee schedule) | $524.60 | $581.92 | 32 of 45 |
| 11006 | Physician and practitioner services (fee schedule) | $469.46 | $540.51 | 33 of 45 |
| 11008 | Physician and practitioner services (fee schedule) | $185.44 | $208.64 | 33 of 45 |
| 11010 | Physician and practitioner services (fee schedule) | $319.15 | $275.93 | 16 of 45 |
| 11011 | Physician and practitioner services (fee schedule) | $367.46 | $303.31 | 16 of 45 |
| 11012 | Physician and practitioner services (fee schedule) | $472.38 | $414.55 | 17 of 45 |
| 11042 | Physician and practitioner services (fee schedule) | $88.82 | $78.71 | 19 of 45 |
| 11043 | Physician and practitioner services (fee schedule) | $164.94 | $164.23 | 22 of 45 |
| 11044 | Physician and practitioner services (fee schedule) | $223.26 | $218.19 | 22 of 45 |
| 11055 | Physician and practitioner services (fee schedule) | $45.63 | $30.69 | 16 of 45 |
| 11056 | Physician and practitioner services (fee schedule) | $53.44 | $35.45 | 16 of 45 |
| 11057 | Physician and practitioner services (fee schedule) | $58.80 | $41.79 | 15 of 45 |
| 11102 | Physician and practitioner services (fee schedule) | $63.44 | $66.99 | 26 of 45 |
| 11103 | Physician and practitioner services (fee schedule) | $32.45 | $33.33 | 26 of 45 |
| 11104 | Physician and practitioner services (fee schedule) | $80.28 | $81.27 | 24 of 45 |
| 11105 | Physician and practitioner services (fee schedule) | $40.50 | $40.62 | 24 of 45 |
| 11106 | Physician and practitioner services (fee schedule) | $100.28 | $96.49 | 22 of 45 |
| 11107 | Physician and practitioner services (fee schedule) | $47.34 | $47.42 | 24 of 45 |
| 11300 | Physician and practitioner services (fee schedule) | $63.93 | $44.47 | 17 of 45 |
| 11301 | Physician and practitioner services (fee schedule) | $77.10 | $60.30 | 17 of 45 |
Managed care in West Virginia
5 plans on record, 0 state-directed payment records.
Who sets the rate, line by line →Recent rate changes and notices
Frequently asked questions
Where does West Virginia publish its Medicaid fee schedules?
West Virginia publishes rates across 62 official documents (fee schedules, rate notices and bulletins). Every rate on this page links to its source document.
How many Medicaid rates does West Virginia publish?
88,707 rates are current across 108 services and 6 programs, with 297,302 versions on record since 2017-01-01.
Do West Virginia Medicaid managed-care plans pay the fee schedule?
For 10 of 21 service lines, plan contracts or state law set a rule plans must follow (a floor, a state-set rate or a required pass-through). For the rest, plans negotiate. See the managed-care page for each line's rule and citation.
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Your West Virginia rate cardYour codes, what West Virginia pays, what plans must pay, and every change in 2026.