Click here to download the Comprehensive Fee Schedule.
Below are the fee schedules and rates listed by codes for particular provider or facility types.
Administered Drug Services
| Clinician Administered Drugs and Implantable Drug System Devices | July 2018 |
| Physician Administered Drugs | January 2023 |
Dental Professional Services
| Dental Fees – Professional Services | January 2023 |
Hearing and Vision Services
| Audiological (Hearing) | January 2023 |
| Vision | January 2023 |
Home and Community Based Services (HCBS) Waivers
| Assisted Living (AL) Waiver | July 2021 |
| Community Transition Services (CTS) | July 2021 |
| Elderly & Disabled (E&D) Waiver | July 2021 |
| Independent Living (IL) Waiver | July 2021 |
| Intellectual and Developmental Disabilities (ID/DD) Waiver | January 2023 |
| Intellectual/Developmental Disabilities 1915(i) Community Support Program | January 2023 |
| Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver | July 2021 |
Hospital Services
| Out-of-State Hospital Transplant Services’ Case Rates | July 2019 |
| Outpatient Prospective Payment System (OPPS) Medicaid | January 2023 |
Laboratory and Radiology Services
| Pathology Laboratory | January 2023 |
| Radiology | January 2023 |
Medical Equipment and Supplies
| Durable Medical Equipment (DME), Orthotic, Prosthetic | March 2023 |
| Medical Supply | February 2023 |
Medical and Surgical Services
| Ambulatory Surgical Centers Fee Schedule for DOS | January 2023 |
| Anesthesia Base Unit | January 2023 |
| Extended Services for the Perinatal High-Risk Management and Infant Service System (PHRMISS) | July 2022 |
| Medical and Surgical Services | January 2023 |
| Prescribed Pediatric Extended Care (PPEC) | October 2022 |
| Private Duty Nursing (PDN) Services | October 2022 |
| Therapy Services | January 2023 |
| Vaccine | October 2022 |
Mental Health Services
| Autism Spectrum Disorder (ASD) Services | January 2023 |
| Community Mental Health Services | January 2023 |
| Medication Assisted Treatment for Opioid Treatment Services | January 2023 |
| Psychiatry and Psychiatric Nurse Practitioners for Mental Health/Psychiatry Services | January 2023 |
| Therapeutic and Evaluative Mental Health Services for Expanded EPSDT (T&E) | January 2023 |
Transport Services
| Ambulance | January 2023 |
Other Rates
Providers must use current CPT, HCPCS, CDT and ICD10 books for correct coding.
Current Dental Terminology (including procedure codes, nomenclature, descriptors and other data contained therein) is copyright © 2018 American Dental Association. All rights reserved. Applicable FARS/DFARS Apply.
CPT only copyright 2019 American Medical Association. All rights reserved.
