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In January 2024, CMS released the 2024-2025 Medicaid Managed Care Rate Development Guide for states to use when setting rates with respect to any managed care program subject to federal actuarial soundness requirements during rating periods starting between July 1, 2024 and June 30, 2025.
managed care plan contracts, and therefore, are expected to have Medicaid FFS fee schedule payment rates in effect. Such Medicaid FFS fee schedule payment rates are subject to the provisions finalized in this rule under § 447.203(b).
CMS issued the CY 2025 Physician Fee Schedule (PFS) final rule to update Medicare PFS. See a summary of provisions effective January 1, 2025. The PFS is the primary method of payment for enrolled health care providers.
Access Medicare Fee Schedules for physicians, ambulance services, clinical laboratory services, DMEPOS, and other Medicare FFS providers.
The Online Fee Lookup provides fee information for Texas Medicaid, including Texas Health Steps (THSteps), the HHSC Family Planning Program and the CSHCN Services Program. Users can also search for fee information for specified procedure codes.
In order to better inform analysis of existing policies and development of future policies that affect Medicaid payments, this state policy compendium documents each state’s fee-for-service physician payment policy, including how individual states set their payment rates, the type of fee schedule they currently use, and the specific ...
What percentage of people are covered by Medicaid in your state? Our State Medicaid fact sheets provide a snapshot with key data for Medicaid in every state related to current coverage,...
Search the Outpatient and Dental Fee Schedule Database Download Medicaid Program Outpatient Fee Schedule The PROMISe™ Outpatient Fee Schedule is available for download in the following formats: Excel, PDF, and Comma Delimited.
Approved Medicaid fee-for-service rates for all OMH programs. Assertive Community Treatment (ACT) - Regional Rate - File updated 11/06/24. Certified Community Behavioral Health Clinics (CCBHC) - File updated 10/7/24. Collaborative Care - Statewide Rate - File updated 6/28/24.
This fee schedule reflects current IHCP coverage and reimbursement policy for procedure codes and revenue codes billed for IHCP outpatient services under the FFS delivery system. It is posted as a Microsoft Excel document, so providers can search and sort as needed.