FINAL REPORT

April 2008

Content: 1. Survey summary and caveats

2. Description of CPT®(Current Procedural Terminology) codes and CDT® (dental) codes included in the Survey

3. Abbreviations

4. Medicaid Managed Care Penetration and Other Notes, by State

5. State-administered Medicaid Fee-for-Service Program Payment Rate, 2007/08, by Commonly Reported CPT code

6. Footnotes, by state

CPT® is a trademark of the American Medical Association. Dental codes (CDT® Codes) are copyright 2006 American Dental Association. Reprinted with permission.

Contact Suk-fong Tang, Department of Practice, for questions about this report. Contact Dan Walter, Division of State Government Affairs, for Medicaid questions and advocacy advice. Contact Elizabeth Sobczyk, Division of Pediatric Practice, for pediatric immunization questions and advocacy advice. Contact the Division of Health Care Finance and Quality Improvement at dhcfqi@aap.org for information on child health financing or RBRVS. Suggested Citation: 2007/08 AAP Medicaid Reimbursement Survey. American Academy of Pediatrics. Elk Grove Village, Illinois. Copyright 2008 American Academy of Pediatrics.

AAP Medicaid Reimbursement Survey, 2007/08

1. Survey Summary and Caveats

As part of its effort to monitor the impact of the Medicaid program on pediatrics, the Academy (AAP) conducts its Medicaid Reimbursement Survey periodically. The Survey, which collects state-level data on Medicaid program information and state-administered fee-for-service program payment rates for most commonly reported pediatric CPT®(Current Procedural Terminology) codes and dental codes, is mailed to State Medicaid Directors in the 50 states and the District of Columbia.

Fees shown in this report represent fee-for-service payments reported by states for state-administered Medicaid programs only. Nationally, the majority of children enrolled in Medicaid programs are enrolled in managed care plans, which may or may not benchmark provider payment rates to fees shown in this report. Attempts by the AAP to collect plan-to-provider payment rates in Medicaid managed care plans have been unsuccessful since such information has typically been classified as “confidential and proprietary” by the states and the plans with which they contract. Depending on managed care penetration levels, the impact of state-administered fee-for-service Medicaid payment rates varies by state. Medicaid managed care penetration rate and state effort to monitor plan-to-provider payment in each state are described in a set of notes at the beginning of this report. (See 4. Medicaid Managed Care Penetration and Other Notes, by State)

The most recently conducted survey, mailed initially in July 2007 with follow-up mailings, email and telephone contact through February 2008, requested payment rates effective July 1, 2007, the beginning of the 2007-08 fiscal year for most states. This report includes payment information provided by the offices of Medicaid Directors in 47 states and the District of Columbia. Data for New York and Hawaii are based on a search of the two states’ Medicaid websites by AAP staff. Tennessee, which does not administer a fee-for-service Medicaid program, is not included in this report. This and earlier AAP Medicaid Reimbursement Survey reports can be found at URL: http://www.aap.org/research/medreimintro.htm See also reports with Medicaid to Medicare payment comparison at the same web address.

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2. Description of CPT® (Current Procedural Terminology) Codes and Dental (HCPCS-D) Codes

PRIMARY CARE CODES Preventive Medicine Services 99381 New patient, under 1 year 99382 New patient, 1 through 4 years 99383 New patient, 5 through 11 years 99384 New patient, 12 though 17 years 99385 New patient, 18 though 39 years 99391 Established patient, under 1 year 99392 Established patient, 1 through 4 years 99393 Established patient, 5 through 11 years 99394 Established patient, 12 though 17 years 99395 Established patient, 18 though 39 years 99401 Individual counseling, 15 minutes 99402 Individual counseling, 30 minutes Office and Other Outpatient Services 99201 New patient, problem-focused 99202 New patient, expanded 99203 New patient, low complexity 99204 New patient, moderate complexity 99205 New patient, high complexity 99211 Established patient, nurse only 99212 Established patient, problem-focused 99213 Established patient, low complexity 99214 Established patient, moderate complexity 99215 Established patient, high complexity 92551 Screening test, hearing evaluation 92567 Tympanometry, hearing evaluation 99173 Screening test, visual acuity Newborn Care 99431 Initial newborn care. 99433 Subsequent newborn care 99435 Admit and discharge on same day 99436 Physician attendance at delivery 99440 Newborn resuscitation

54150 Circumcision, using clamp or other device with regional dorsal penile or ring block

Immunization Services 90465 One immunization administration, physician counseling < 8 yrs. 90466 Each additional immunization administration, physician counseling < 8 yrs

90467 One immunization administration, oral or intranasal, physician counseling < 8 yrs

90468 Each additional immunization administration, oral or intranasal, physician counseling < 8 yrs

90471 One immunization administration 90472 Each additional immunization administration 90473 One immunization administration, oral or intranasal 90474 Each additional administration, oral or intranasal 90645-8 Hemophilus Influenza B 90649 HPV 90657 Influenza virus (6-35 months)

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90658 Influenza virus (3+ years) 90660 Influenza virus, intranasal use 90669 Pneumococcal conjugate vaccine 90680 Rotavirus. 90700 DTaP (< 7 years) 90701 DTP 90702 DT (< 7 years) 90707 Measles-Mumps-Rubella 90713 IPV 90715 Tdap 90716 Varicella 90718 Td (³ 7 years) 90721 DTaP-HIB 90723 DTaP-HepB-IPV 90744 Hepatitis B, (pediatric/adolescent age) Observation 99217 Observation care discharge, day management 99218 Initial observation care, low severity. 99219 Initial observation care, intermediate severity 99220 Initial observation care, high severity. Prolonged Physician Services 99354 Prolonged service outpatient, 1st hour, face-to-face 99355 Same as 99354, each additional 30 minutes 99356 Prolonged service, inpatient, 1st hour, face-to-face 99357 Same as 99356, each additional 30 minutes 99358 Prolonged service, 1st hour, not face-to-face. 99359 Same as 99358, each additional 30 minutes Team Medical Conferences 99361 Team medical conference, 30 minutes 99362 Team medical conference, 60 minutes Telephone Care 99371 Telephone call – simple or brief 99372 Telephone call - intermediate 99373 Telephone call – complex or lengthy Care Plan Oversight 99339 Supervision of patient in home, 15-29 minutes per month 99340 Same as 99339, 30 minutes or more per month 99374 Supervision of patient under home health agency care, 15-29 minutes per month 99375 Same as 99374, 30 minutes or more per month Hospital Care 99221 Initial hospitalization, per day, low complexity 99222 Initial hospitalization, per day, moderate complexity 99223 Initial hospitalization, per day, high complexity 99231 Subsequent hospitalization, per day, low complexity 99232 Subsequent hospitalization, per day, mod. complexity 99233 Subsequent hospitalization, per day, high complexity Hospital Discharge 99238 Hospital discharge, day management, 30 min or less 99239 Hospital discharge, day management, more than 30 minutes Consultations 99241 Office consultation, problem focused 99242 Office consultation, expanded 99243 Office consultation, low complexity

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99244 Office consultation, moderate complexity 99245 Office consultation, high complexity 99254 Initial inpatient consultation, moderate complexity 99255 Initial inpatient consultation, high complexity Pathology and Laboratory 81000 Urinalysis, non-automated with microscopy 81002 Urinalysis, non-automated without microscopy 86580 Tuberculosis, intradermal. 87081 Throat culture 87880 Rapid Streptococcus screen Mental Health 90801 Psychiatric diagnostic interview examination 90804 Individual psychotherapy, 20-30 minutes face-to-face 90806 Individual psychotherapy, 45-50 minutes face-to-face 90808 Individual psychotherapy, 75-80 minutes face-to-face 90862 Pharmacologic management 90887 Interpretation or explanation of results Developmental Testing 96110 Developmental testing, limited 96111 Developmental testing, extended SUBSPECIALTY CARE CODES Allergy/Immunology 95004 Percutaneous tests with allergenic extracts 95010 Percutaneous tests, sequential and incremental 95015 Intracutaneous tests, with biologicals 95024 Intracutaneous tests, with allergenic extracts 95115 Allergen immunotherapy, single injection 95117 Allergen immunotherapy, two or more injections Cardiology 32020 Thoracostomy tube 92950 Cardiopulmonary resuscitation 93303 Transthoracic echocardiography 93307 Echocardiography, real-time with image documentation 93320 Doppler echocardiograph 93501 Right heart catheterization 93510 Left heart catheterization Procedures 31500 Intubation, endotracheal 36555 Insertion of non-tunneled center venous cathether; < 5 yrs 36568 Insertion of peripherally inserted CVC; under 5 years 36600 Arterial puncture, diagnostic 36620 Arterial line placement 36510 Umbilical vein catheterization 36660 Umbilical artery catheterization 10120 Simple surgical removal of foreign body 12015 Simple surgical repair of facial wounds (7.6 - 12.5 cm) 36400 Venipuncture necessitating physician skill; < 3 years 36410 Venipuncture necessitating physician skill; >= 3 yrs 36415 Routine venipuncture 36416 Finger, heel, ear stick 62270 Lumbar puncture, diagnostic

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Moderate Sedation

99143

Moderate sedation provided by same physician performing the service that sedation supports; younger than 5 years of age, first 30 minutes intra-service time

99144 Moderate sedation provided by same physician performing the service that sedation supports; age 5 years or older, first 30 minutes intra-service time

99145 Moderate sedation provided by same physician performing the service that sedation supports; each additional 15 minutes intra-service time

99148

Moderate sedation provided by a physician other than the health care professional performing the service that the sedation supports; younger than 5 years of age, first 30 minutes intra-service time

99149

Moderate sedation provided by a physician other than the health care professional performing the service that the sedation supports; age 5 years or older, first 30 minutes intra-service time

99150

Moderate sedation provided by a physician other than the health care professional performing the service that the sedation supports; each additional 15 minutes intra-service time

Emergency Care 99282 ED visit, problem focused 99283 ED visit, expanded 99284 ED visit, detailed Gastrointestinal 43239 Upper gastrointestinal endoscopy with biopsy 44389 Colonoscopy with biopsy 45331 Sigmoidoscopy with biopsy Ophthalmology 67311 Strabismus surgery, horizontal 67314 Strabismus surgery, vertical 68810 Nasolacrimal probing Otolaryngology 42820 Tonsillectomy/adenoidectomy, under 12 years 42821 Tonsillectomy/adenoidectomy, over 12 years 69436 Tympanostomy and tubes Critical Care 99291 Critical care, first hour 99292 Critical care, additional 30 minutes 99293 Initial pediatric critical care 99294 Subsequent pediatric critical care 99295 Initial neonatal critical care 99296 Subsequent neonatal critical care Intensive Low Birth Weight Services 99298 Subsq intensive care, < 1500 gm present body weight 99299 Subsq intensive care, 1500-2500 gm present body weight 99300 Subsq intensive care, 2501-5000 gm present body weight Plastic Surgery 40700 Cleft lip repair 42200 Cleft palate repair

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Pulmonology 31622 Bronchoscopy 32000 Thoracentesis 94010 Spirometry, including graphic record 94640 Inhalation treatment 94644 Continuous inhalation treatment, first hour 94645 Same as 94644, each additional hour 94664 Demonstration/evaluation Radiology 71010 Frontal chest x-ray Surgery 28262 Extensive clubfoot release 44950 Appendectomy 49500 Bilateral inguinal hernia, 6 months to under 5 years 49505 Bilateral inguinal hernia, 5 years or over Nephrology 50200 Renal biopsy 90918 ESRD (end stage renal disease) services, under 2 years 90919 ESRD services, 2 through 11 years 90920 ESRD services, 12 through 19 years 90945 Peritoneal dialysis Dental Services Dental codes (CDT® Codes) are copyright 2006 American Dental Association. Reprinted with permission. D0120 Periodic exam D1203 Topical fluoride treatment, child D1120 Prophylaxis, child D2150 Amalgam – two surfaces, primary or permanent D2330 Resin-based composite – one surface anterior D1351 Sealant, per tooth D2930 Stainless steel crown on a primary tooth D3220 Pulpotomy D7140 Extraction

CPT® is a trademark of the American Medical Association.

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3. Abbreviations

Abbreviation Description BC

Billed charges

BI / BR / PR

By invoice/ by report/ per review, i.e., Carrier will establish payment amounts for these services on a case-by-case basis following review of documentation, such as an operative report.

BO Bundled with other services, i.e., Payment for covered services is always bundled into payment for other services not specified. If these services are covered, payment for them is subsumed by the payment for the services to which they are incident.

FFS Fee-for-service / discounted fee-for-service

MP Manually priced, i.e., Carrier will establish payment amounts for these services, generally on a case-by-case basis following review of documentation, such as an operative report.

NA Not applicable

NC Not covered

NL Information not found on state Medicaid website / fee schedule

NP Information not provided by state in returned survey

OM Other method used

RNE Rate Not Established

VFC Vaccines for Children Program. Providers are typically paid a vaccine administration fee for administering vaccines made available through VFC programs.

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4. Medicaid Managed Care Penetration and Other Notes, by State

State Notes

Alabama

All children in Alabama's Medicaid program were covered by a state-administered fee-for-service plan for non-hospital care according to state reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Alaska

All children in Alaska's Medicaid program were covered by a state-administered fee-for-service plan according to state reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Arizona

90.3% of children enrolled in AZ Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State did not monitor any plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Arkansas

All children in Arkansas's Medicaid program were covered by astate-administered fee-for-service plan according to state reply to the 2007/8 AAP Medicaid Reimbursement Survey.

California

70.8% of children enrolled in CA Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State monitored both FFS and capitated plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Colorado

93.7% of children enrolled in CO Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State monitored capitated plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Connecticut

95.5% of children enrolled in CT Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State monitored FFS plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey. Note: Pediatric payments for preventive visits, office visits and mental health services (rates shown in this report for CT) are 80%-120% higher than regular (non-pediatric rates) rates.

Delaware

95.1% of children enrolled in DE Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State did not monitor plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Dist of Columbia

88.1% of children enrolled in DC Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State monitored FFS plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Florida

65.6% of children enrolled in FL Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State did not monitor plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey. Note: Rates shown in this report represent regular rates paid by FL Medicaid. Board-certified pediatric surgeons and certain other specialties receive enhanced pediatric specialty rates at 124% of regular rates for certain procedures.

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Georgia

88.2% of children enrolled in GA Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State monitored capitated plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Hawaii

State did not respond to 2007/8 AAP Medicaid Reimbursement Survey. FFS payment rates shown in this report are based on a search of state Medicaid website (URL: http://www.med-quest.us/) conducted by AAP staff. 95.5% of children enrolled in HI Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. Note: Rates shown in this report for HI are either for EPSDT or "Mandated Services", which are higher than regular Medicaid rates.

Idaho 100% of children enrolled in ID Medicaid were in a state-administered FFS plan according to FY2005 CMS data.

Illinois

15.1% of children enrolled in IL Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State monitored capitated plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Indiana

76.2% of children enrolled in IN Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State did not monitor plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Iowa

93.4% of children enrolled in IA Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State monitored FFS plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Kansas

43.3% of children enrolled in KS Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State did not indicate whether it monitored plan-to-provider payment rates in its Medicaid managed care plan(s) in its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Kentucky

98.7% of children enrolled in KY Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State monitored both FFS and capitated plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Louisiana

All children in Louisiana's Medicaid program were covered by a state-administered fee-for-service plan according to state reply to the 2007/8 AAP Medicaid Reimbursement Survey. Note: Where available, enhanced rates reimbursed for Professional Services (Physician) and/or Community Care/EPSDT programs are shown in this report.

Maine

All children in Maine's Medicaid program were covered by a state-administered fee-for-service plan according to state reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Maryland

94.1% of children enrolled in MD Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State indicated that FFS plan-to-provider payment rates in its Medicaid managed care plan(s) were about 110% of state-administered FFS rates in its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Massachusetts

81.6% of children enrolled in MA Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State monitored both FFS and capitated plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

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Michigan

94.3% of children enrolled in MI Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State did not monitor plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Minnesota

82.8% of children enrolled in MN Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State did not monitor plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Mississippi

All children enrolled in MS Medicaid were covered by a state-administered FFS program according to state reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Missouri

59.3% of children enrolled in MO Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State did not monitor plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Montana

All children enrolled in MT Medicaid were covered by a state-administered FFS program according to FY2005 CMS/MSIS data. Note: Dental rates shown in this report for MT are EPSDT rates, which are higher than regular Medicaid rates.

Nebraska

18.8% of children enrolled in NE Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State monitored FFS plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Nevada

93.1% of children enrolled in NV Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State did not monitor plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey. Note: Rates shown in this report for NV include regular Medicaid rates and, if available, enhanced pediatric rates.

New Hampshire

All children enrolled in NH Medicaid were covered by a state-administered FFS program according to state reply to the 2007/8 AAP Medicaid Reimbursement Survey.

New Jersey

87.6% of children enrolled in NJ Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State did not indicate whether it monitored plan-to-provider payment rates in its Medicaid managed care plan(s) in its reply to the 2007/8 AAP Medicaid Reimbursement Survey. Note: Rates shown in this report for NJ are regular FFS rates. Payments for specialists are typically 14%-29% above regular rate.

New Mexico

91.5% of children enrolled in NM Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State did not monitor plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

New York

State did not respond to 2007/8 AAP Survey. FFS payment rates shown in this report are based on a search of state Medicaid website (URL: http://www.emedny.org/ProviderManuals/ Physician/index.html) conducted by AAP staff. Information posted on this website suggests that payment varies by provider specialty. Rates shown in this report reflect rates paid primary care providers, which are typically lower than payment for specialists. 78.0% of children enrolled in NY Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. Payment levels in some of NY's Medicaid managed care plans are, reportedly, substantially higher than rates paid by state-administered FFS plan(s).

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North Carolina

All children enrolled in NC Medicaid were covered by a state-administered FFS program according to state reply to the 2007/8 AAP Medicaid Reimbursement Survey.

North Dakota

All children enrolled in ND Medicaid were covered by a state-administered FFS program according to state reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Ohio

44.7% of children enrolled in OH Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State did not monitor plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Oklahoma

All children enrolled in OK Medicaid were covered by a state-administered FFS program according to state reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Oregon

91.4% of children enrolled in OR Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State did not monitor plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Pennsylvania

75.7% of children enrolled in PA Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State monitored both FFS and capitated plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Rhode Island

90.1% of children enrolled in RI Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State did not monitor plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

South Carolina

17.4% of children enrolled in SC Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State monitored both FFS and capitated plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey. Note: Payments shown in this report for SC are regular rates. Reimbursement to pediatric sub-specialists is generally higher, paid at 120% of Medicare for E&M codes and 100% of Medicare for most other codes.

South Dakota

100% of children enrolled in SD Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State did not indicate whether it monitored plan-to-provider payment rates in its Medicaid managed care plan(s) in its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Tennessee

TN's Medicaid program, TennCare, is 100% managed care. All TN Medicaid children were covered in TennCare (Medicaid managed care) according to state response to 2007/8 AAP Medicaid Reimbursement Survey. State did not indicate whether it monitored plan-to-provider payment rates in its Medicaid managed care plan(s) in its reply to the same survey.

Texas

43.6% of children enrolled in TX Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State monitored both FFS and capitated plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

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Utah

91.2% of children enrolled in UT Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State monitored FFS plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Vermont

All children enrolled in VT Medicaid were covered by a state-administered FFS program according to state reply to the 2007/8 AAP Medicaid Reimbursement Survey. Note: Pediatric payments for E&M codes are enhanced (20% above regular level, as shown in this report for VT).

Virginia

64.5% of children enrolled in VA Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State monitored capitated plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Washington

75.2% of children enrolled in WA Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State did not monitor plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

West Virginia

62.3% of children enrolled in WV Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State did not monitor plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey.

Wisconsin

64.7% of children enrolled in WI Medicaid were in prepaid plans according to FY2005 CMS data - state-administered FFS rates shown in this report may apply to certain carved-out services only for these children. State monitored capitated plan-to-provider payment rates in its Medicaid managed care plan(s) according to its reply to the 2007/8 AAP Medicaid Reimbursement Survey. Note: Enhanced reimbursement for pediatric office and ED visits (rates shown in this report for WV) can be coupled with a 20% health professional service area (HPSA) bonus when patient or provider comes from a HPSA eligible zip code.

Wyoming

All children enrolled in WY Medicaid were covered by a state-administered fee-for-service program according to state reply to the 2007/8 AAP Medicaid Reimbursement Survey.

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5.

State-administered Medicaid Fee-for-Service Program Payment Rate, 2007/08,

by Commonly Reported CPT code

1

State* PRIMARY CARE CODES : Preventive Medicine Services 99381 99382 99383 99384 99385 99391 99392 99393 99394

Alabama NC NC NC NC NC $27.00 $27.00 $27.00 $27.00 Alaska $138.46 $149.29 $147.09 $159.53 $153.53 $107.82 $120.26 $119.16 $131.10 Arizona $94.16 $101.46 $99.96 $108.41 $108.41 $73.28 $81.73 $80.98 $89.03 Arkansas $56.41 $56.41 $56.41 $56.41 $56.41 $56.41 $56.41 $56.41 $56.41 California $45.33 $47.13 $54.83 $65.78 NC $34.69 $37.39 $43.85 $54.83 Colorado $55.05 $55.05 $55.05 $55.05 $55.05 $69.02 $77.31 $40.15 $40.15 Connecticut $93.60 $93.60 $93.60 $93.60 $93.60 $93.60 $93.60 $93.60 $93.60 Delaware $95.67 $103.08 $101.53 $110.05 $110.05 $74.40 $82.91 $82.14 $90.32 Dist of Columbia $80.00 $45.00 $45.00 $60.00 $60.00 $30.00 $30.00 $30.00 $45.00 Florida $71.59 $71.59 $71.59 $71.59 $71.59 $71.59 $71.59 $71.59 $71.59 Georgia $67.38 $67.38 $55.38 $55.38 $55.38 $67.38 $67.38 $67.38 $55.38 Hawaii $95.00 $95.00 $95.00 $95.00 $95.00 $95.00 $95.00 $95.00 $95.00 Idaho $104.89 $117.73 $116.98 $130.47 $130.47 $86.69 $99.80 $99.42 $112.64 Illinois $91.9* $98.65* $98.60* $104.96* $104.96* $69.52* $77.87* $76.84* $84.62* Indiana $39.85 $34.52 $38.82 $32.00 $48.94 $24.35 $24.36 $25.01 $25.32 Iowa $91.55 $98.26 $97.59 $108.61 $105.30 $74.71 $82.48 $82.15 $92.94 Kansas $40.00 $35.00 $35.00 $35.00 $30.00 $26.00 $25.00 $25.00 $25.00 Kentucky $78.58 $89.90 $89.90 $101.22 $95.21 $67.57 $78.58 $78.58 $89.90 Louisiana $58.65 $58.65 $58.65 $58.65 $58.65 $58.65 $58.65 $58.65 $58.65 Maine $47.15 $48.48 $50.40 $49.87 $45.43 $43.75 $44.50 $45.25 $46.50 Maryland $85.95 $92.36 $90.41 $98.07 $98.07 $64.94 $72.60 $71.62 $79.02 Massachusetts $87.85* $93.77* $92.47* $99.25* $99.25* $70.36* $77.14* $76.49* $83.06* Michigan $86.72 $93.36 $91.46 $99.37 $99.37 $65.83 $73.74 $72.79 $80.39 Minnesota $35.43 $30.28 $32.96 $34.60 $42.48 $25.54 $25.95 $25.95 $28.84 Mississippi $80.78 $87.40 $85.74 $93.37 $93.37 $61.58 $69.19 $68.54 $76.15 Missouri $60.00 $60.00 $60.00 $60.00 NP $60.00 $60.00 $60.00 $60.00 Montana $97.94 $104.66 $102.96 $110.80 $94.89 $78.51 $86.39 $85.54 $93.08 Nebraska $90.82 $95.60 $105.16 $114.72 $124.28 $76.48 $81.26 $86.04 $90.82 Nevada $59.07 $59.07 $59.07 $59.07 $59.07 $59.07 $59.07 $59.07 $59.07 New Hampshire $44.80 $44.80 $44.80 $47.04 $40.32 $62.07 $62.07 $62.07 $62.07 New Jersey $25.00 $25.00 $25.00 $25.00 $25.00 $25.00 $25.00 $25.00 $25.00 New Mexico $150.55 $150.55 $150.55 $150.55 $150.55 $89.83 $89.83 $89.83 $89.83 New York $30.00 $30.00 $30.00 $30.00 $30.00 $30.00 $30.00 $30.00 $30.00 North Carolina $80.33 $80.33 $80.33 $98.51 $98.51 $80.33 $80.33 $80.33 $81.57 North Dakota $84.09 $90.72 $89.62 $97.73 $97.73 $66.02 $73.76 $73.02 $80.40 Ohio $50.70 $57.61 $57.51 $64.52 $61.21 $44.18 $51.12 $51.12 $58.36 Oklahoma $85.71 $92.69 $91.39 $74.76 $99.54 $67.23 $75.00 $74.35 $81.98 Oregon $71.10 $76.55 $75.00 $81.40 $81.48 $53.98 $60.46 $59.69 $65.91 Pennsylvania $20.00 $20.00 $20.00 $20.00 $20.00 $20.00 $20.00 $20.00 $20.00 Rhode Island $37.00 $37.00 $37.00 $42.00 $27.24 $27.00 $27.00 $27.00 $27.00 South Carolina $78.75 $78.75 $78.75 $78.75 $78.75 $63.00 $63.00 $63.00 $63.00 South Dakota $53.05 $53.05 $53.05 $53.05 $53.05 $53.05 $53.05 $53.05 $53.05 Texas $84.51 $92.47 $92.09 $100.43 $100.43 $77.75 $85.07 $84.72 $92.40 Utah $67.84 $77.00 $77.00 $86.17 $81.85 $57.09 $66.22 $66.22 $75.39 Vermont $101.10 $109.01 $106.81 $116.01 $116.01 $76.85 $86.06 $106.81 $116.01 Virginia $83.04 $89.72 $88.45 $96.09 $96.09 $64.90 $72.55 $71.91 $79.22 Washington $71.60 $79.23 $82.41 $88.78 $90.69 $54.73 $62.69 $66.19 $72.55 West Virginia $69.40 $75.30 $74.42 $81.21 $76.78 $54.63 $61.42 $61.13 $67.32 Wisconsin $56.96 $56.96 $56.96 $56.96 $56.96 $56.96 $56.96 $56.96 $56.96 Wyoming $120.12 $129.32 $126.69 $137.65 $137.65 $91.18 $102.14 $100.83 $111.35

Source: 2007/8 AAP Medicaid Reimbursement Survey. Copyright 2008 American Academy of Pediatrics. * See abbreviations and (foot)notes, by state, at front and end of report.

2

State* Preventive Medicine Services Office and Other Outpatient Services 99395 99401 99402 99201 99202 99203 99204 99205 99211

Alabama $27.00 $13.00 $13.00 $30.00 $53.00 $78.00 $111.00 $142.00 $17.00 Alaska $132.20 $55.70 $93.20 $52.47 $91.30 $134.86 $205.50 $257.98 $29.53 Arizona $89.79 $37.85 $63.21 $35.75 $62.12 $91.83 $139.68 $175.29 $20.13 Arkansas $56.41 $11.29 $10.85 $29.70 $45.10 $64.90 $88.00 $137.50 $14.30 California NC $7.16 NC $24.98 $34.30 $62.41 $75.17 $90.23 $13.09 Colorado $40.15 $9.02 $12.01 $24.78 $47.43 $83.27 $117.74 $124.54 $12.18 Connecticut $93.60 $36.01 $60.35 $34.44 $55.16 $82.42 $117.13 $148.93 $22.49 Delaware $91.09 $38.54 $64.23 $36.23 $62.94 $92.89 $141.31 $177.27 $20.50 Dist of Columbia $45.00 $175.00 NA $25.00 $32.97 $48.77 $69.36 $88.28 $15.00 Florida $71.59 * * $32.44 $34.01 $50.62 $71.59 $90.97 $12.97 Georgia $55.38 NC NC $35.13 $54.57 $76.53 $110.51 $137.51 $17.46 Hawaii $95.00 NL NL $95.00 $95.00 $95.00 $99.17 $122.28 $95.00 Idaho $113.01 $40.60 $68.66 $33.51 $60.59 $90.53 $129.18 $164.74 $19.69 Illinois $85.65* NA NA $29.55* $33.60* $43.55* $69.65* $74.10* $12.88* Indiana $34.82 MP MP $20.82 $33.96 $46.85 $70.14 $88.36 $9.98 Iowa $90.61 NC $20.60 $38.00 $59.66 $83.97 $121.58 $151.57 $18.68 Kansas $17.00 NL $20.00 $30.91 $50.66 $75.45 $107.12 $136.62 $16.36 Kentucky $84.80 NA NA $29.66 $53.00 $79.04 $112.47 $143.29 $16.98 Louisiana $58.65 NC NC $27.19 $48.57 $72.53 $103.01 $131.47 $15.49 Maine $47.78 $5.00 $20.00 $21.92 $32.56 $48.45 $68.76 $87.34 $13.17 Maryland $80.00 NC NC $30.27 $53.50 $79.45 $116.01 $145.36 $18.07 Massachusetts $83.71* NC NC $39.42* $60.94* $85.00* $123.72* $152.46* $26.84* Michigan $81.34 NC NC $20.88 $37.03 $55.12 $77.94 $99.04 $12.27 Minnesota $32.44 $10.30 $20.60 $27.19 $30.48 $36.25 $61.80 $90.64 $12.36 Mississippi $76.81 $18.90 NC $30.10 $53.86 $80.25 $114.09 $145.70 $17.21 Missouri NP NC $10.00 $25.30 $42.05 $62.62 $88.68 $112.84 $16.50 Montana $78.22 $33.20 $56.83 $29.23 $52.23 $77.92 $110.70 $141.35 $16.67 Nebraska $95.60 $21.14 $42.32 $31.07 $45.41 $66.92 $95.60 $124.28 $16.73 Nevada $59.07 $35.08 NA $29.54 $53.54 $80.31 $113.85 $144.62 $17.85 New Hampshire $40.32 $16.80 $28.00 $50.00 $33.60 $42.56 $63.84 $80.64 $18.38 New Jersey $25.00 NC NC $20.60 $20.60 $25.00 $25.00 $25.00 $14.00 New Mexico $89.83 NC NC $36.27 $64.68 $96.41 $136.80 $174.42 $20.88 New York $30.00 NL NL $30.00 $30.00 $30.00 $30.00 $30.00 $30.00 North Carolina $81.57 NC NC $32.01 $56.13 $83.11 $124.45 $158.30 $17.91 North Dakota $81.14 NC NC $31.72 $55.69 $82.61 $126.50 $159.32 $17.33 Ohio $55.66 NC $36.01 $21.81 $34.42 $48.01 $70.32 $87.97 $13.43 Oklahoma $82.63 $34.60 $58.61 $32.13 $56.60 $83.80 $128.82 $162.20 $17.83 Oregon $66.91 $28.80 $48.53 $25.17 $44.63 $66.43 $93.94 $119.37 $14.79 Pennsylvania $20.00 NC NC $20.00 $23.00 $25.00 $27.00 $36.00 $20.00 Rhode Island $27.00 NC NC $16.72 $27.24 $29.00 $45.00 $46.00 $8.05 South Carolina NC $33.42 $56.85 $28.97 $51.71 $76.81 $109.10 $139.12 $16.82 South Dakota $53.05 NL NL $31.80 $49.12 $73.00 $103.66 $132.23 $15.82 Texas $92.40 NC NC $28.87 $45.56 $61.56 $90.07 $111.98 $14.96 Utah $71.89 $24.32 $29.91 $25.54 $45.30 $67.42 $95.34 $121.15 $15.01 Vermont $95.07 $41.13 $69.44 $42.73 $75.96 $112.79 $159.79 $203.29 $25.13 Virginia $79.86 ** ** $28.73 $49.37 $71.40 $109.34 $138.07 $15.35 Washington $75.10 $23.35 NC $31.82 $55.37 $82.10 $125.37 $157.83 $17.82 West Virginia $63.78 NC $20.00 $25.10 $44.30 $65.85 $100.99 $127.27 $13.58 Wisconsin $56.96 NC NC $28.23 $48.89 $81.22 $118.15 $163.25 $13.00 Wyoming $112.66 $25.00 $81.98 $42.52 $75.40 $112.23 $158.69 $201.66 $24.99

Source: 2007/8 AAP Medicaid Reimbursement Survey. Copyright 2008 American Academy of Pediatrics. * See abbreviations and (foot)notes, by state, at front and end of report.

3

State* Office and Other Outpatient Services Newborn Care 99212 99213 99214 99215 92551 92567 99173 99431 99433

Alabama $31.00 $42.00 $67.00 $98.00 $15.75 $14.00 NC $50.00 $28.00 Alaska $59.13 $87.35 $132.49 $179.43 $14.29 $31.15 $3.81 $81.20 $42.95 Arizona $36.88 $55.48 $84.15 $121.84 $10.12 $22.27 NP $55.06 $29.09 Arkansas $27.50 $36.30 $70.05 $106.00 $9.90 $16.50 $14.08 $108.16 NC California $19.75 $26.18 $40.91 $62.41 $11.13 NC $2.30 $53.79 $29.78 Colorado $32.82 $45.75 $71.46 $103.60 $10.64 $8.68 $10.08 $62.55 $35.50 Connecticut $34.55 $45.10 $70.74 $103.83 $8.34 $11.08 $24.44 $28.52 $28.05 Delaware $37.39 $60.18 $91.23 $123.45 $46.21 $21.71 $2.65 $55.55 $29.40 Dist of Columbia $19.37 $27.11 $42.24 $61.53 $8.25 $11.51 $15.00 $75.00 $36.00 Florida $26.45 $32.56 $48.27 $62.69 NC $11.23 NC $30.43 $16.13 Georgia $29.67 $40.70 $62.71 $93.46 NP NP $5.62 NP NP Hawaii $95.00 $95.00 $95.00 $95.00 $10.13 $17.78 NL $95.00 $31.16 Idaho $35.58 $49.56 $77.98 $114.78 $14.14 $18.22 $25.50 $87.21 $30.93 Illinois $45.50* $46.56* $72.97* $49.95* $15.20 $15.20 $18.16* $38.75 NC Indiana $18.20 $25.98 $40.43 $63.87 $11.42 $14.09 $9.98 $55.33 $23.23 Iowa $32.36 $44.61 $68.93 $103.15 $14.57 $18.83 BR $71.46 $38.16 Kansas $29.76 $40.84 $64.22 $94.00 $13.83 $17.73 $5.00 $75.00 NL Kentucky $31.08 $42.63 $67.10 $98.39 $12.24 $14.87 $45.00 $68.73 $36.33 Louisiana $30.13 $36.13 $61.40 $90.13 $3.60 $22.50 $4.00 $54.00 $45.00 Maine $19.85 $28.94 $42.50 $30.36 $9.01 $10.15 NC $46.81 $21.59 Maryland $31.90 $49.56 $75.06 $101.36 $5.29 $23.73 $4.80 $48.89 $25.69 Massachusetts $40.39* $58.67* $83.71* $109.52* $8.33 $17.85 $2.16 $63.30 $33.55 Michigan $21.96 $29.93 $46.94 $68.25 $10.33 $12.49 NC $50.64 $26.59 Minnesota $20.60 $24.72 $46.14 $65.92 $8.91 $13.15 NL $49.82 $23.17 Mississippi $31.54 $43.54 $68.23 $100.12 $8.82 $16.36 $8.82 $52.01 $27.36 Missouri $27.50 $32.03 $48.57 $77.69 $29.20 $5.00 NC $60.00 $24.75 Montana $30.61 $41.96 $66.11 $96.99 $9.45 $14.89 47% BC $50.40 $26.48 Nebraska $28.68 $43.02 $64.53 $93.21 $12.85 $12.33 $1.84 $105.16 $47.80 Nevada $31.69 $44.00 $68.62 $100.93 $12.15 $25.17 NA $50.16 $26.77 New Hampshire $31.18 $39.15 $65.79 $75.04 $5.00 $8.00 $5.00 $62.07 $28.00 New Jersey $20.60 $20.60 $20.60 $20.60 NC $5.00 $5.00 $33.80 $20.60 New Mexico $38.03 $52.08 $81.91 $119.87 $11.56 $20.49 $41.47 $67.63 $35.54 New York $30.00 $30.00 $30.00 $30.00 $5.00 $10.00 NL $6.50 $5.00 North Carolina $33.01 $47.67 $74.87 $109.29 $8.53 $18.29 NC $50.55 $26.92 North Dakota $32.45 $53.84 $81.50 $110.64 $8.11 $17.33 $2.21 $50.89 $27.29 Ohio $24.74 $34.35 $52.57 $81.04 $6.27 $14.67 NC $55.41 $28.83 Oklahoma $33.10 $54.91 $83.28 $112.83 $8.25 $17.40 $6.84 $51.86 $27.67 Oregon $26.47 $36.07 $56.57 $82.26 $11.71 $15.05 $7.27 $41.52 $21.80 Pennsylvania $26.00 $27.00 $29.00 $36.00 $8.00 $12.00 $6.00 $42.00 $17.00 Rhode Island $20.64 $20.64 $27.00 $32.00 $8.00 $11.56 NC $38.18 $24.00 South Carolina $30.41 $41.81 $65.70 $96.00 $9.02 $15.72 NC $49.25 $25.98 South Dakota $28.57 $39.93 $62.59 $91.34 $11.96 $15.51 $12.13 $72.14 $30.97 Texas $25.04 $37.64 $52.86 $81.38 $15.75 $16.91 NC $80.36 $38.82 Utah $26.86 $36.60 $57.41 $83.49 $7.79 $15.27 NC $42.13 $22.12 Vermont $44.94 $61.55 $96.54 $140.47 $15.10 $15.22 $4.50 $59.25 $31.22 Virginia $28.73 $47.70 $71.96 $96.79 $7.07 $15.50 $64.04 $43.79 $23.16 Washington $32.77 $53.46 $80.82 $107.78 $109.78 $12.56 BO $49.96 $26.41 West Virginia $25.99 $42.23 $64.08 $87.70 $6.50 $14.77 NC $40.75 $21.26 Wisconsin $23.41 $32.30 $56.67 $74.46 $12.56 $17.03 * $107.36 $33.20 Wyoming $44.71 $60.94 $95.57 $138.97 $17.38 $25.43 NC $70.14 $36.82

Source: 2007/8 AAP Medicaid Reimbursement Survey. Copyright 2008 American Academy of Pediatrics. * See abbreviations and (foot)notes, by state, at front and end of report.

4

State* Newborn Care Immunization Services 99435 99436 99440 54150 90465 90466 90467Alabama $68.00 $66.00 $123.00 $172.00 $8.00 NA NA Alaska $110.03 $103.42 $202.73 $187.22 $28.43 $15.29 $18.51 Arizona $74.61 $70.09 $137.43 NL NL NL NL Arkansas $108.16 $92.30 $105.60 $197.22 NC NC NC California NC $70.59 $125.47 NC NC NC NC Colorado $80.75 $80.58 $112.42 $39.42 $6.50 $6.50 $6.50 Connecticut $38.52 $36.16 $70.93 $139.55 $9.18 $5.30 $6.43 Delaware $75.38 $70.74 $138.69 $128.84 $19.73 $10.53 $12.77 Dist of Columbia $75.00 $40.00 $75.65 $148.49 NA NA NA Florida $41.25 $39.01 $76.18 $91.09** NC NC NC Georgia NP NP NP NP NC NC NC Hawaii $95.00 $45.00 $45.00 $84.95 NL NL NL Idaho $75.97 $74.58 $152.58 $279.62 $16.81 $10.13 $12.21 Illinois $42.55 $83.70 $94.50 $77.50 NA NA NA Indiana $83.67 $83.67 $106.70 $65.45 $12.94 $7.72 NC Iowa $91.59 $90.92 $179.08 $166.62 NC NC NC Kansas $75.00 $61.56 $131.37 $181.08 $14.88 $14.88 $14.88 Kentucky $88.02 $85.68 $172.13 $67.93 NA NA NA Louisiana $54.00 NC $135.00 $81.00 NC** NC** NC** Maine $58.00 $60.20 $95.95 $116.87 $9.13 $5.49 $6.57 Maryland $65.91 $62.01 $126.27 $66.31 * * * Massachusetts $86.19 $56.30 $158.50 $103.73 $16.19 $8.51 $10.35 Michigan $68.05 $64.25 $125.96 $136.28 $7.00 $7.00 $3.00 Minnesota $60.54 $71.10 $102.74 $54.84 NL NL $1.50 Mississippi $69.53 $110.00 $129.50 NC $10.00 $10.00 $10.00 Missouri $73.56 $55.00 $150.00 $68.60 $10.30 $5.49 $6.70 Montana $67.33 $80.01 NP $184.85 $14.13 $14.13 $14.13 Nebraska $121.89 $93.59 $102.76 $84.51 NC NC NC Nevada $65.54 $64.31 $132.00 $244.30 $21.87 $13.32 NA New Hampshire $75.60 $75.40 $78.40 $80.00 $3.00 $3.00 $3.00 New Jersey $33.80 $33.80 $58.80 $14.00 $11.50 $11.50 $5.00 New Mexico $90.52 $85.88 $168.33 $231.61 NC NC NC New York $6.50 NL $25.00 $12.00 NL NL NL North Carolina $68.55 $64.57 $126.65 $114.99 $17.25 $9.71 $11.27 North Dakota $68.97 $64.91 $127.60 NC $8.77 $6.03 $5.93 Ohio $70.21 $70.67 $103.98 $104.74 NC NC NC Oklahoma $70.18 $66.29 $129.98 $115.75 $13.33 $13.33 $13.33 Oregon $55.79 $52.68 $103.28 $164.26 $12.72 $7.53 $9.08 Pennsylvania $42.00 NC $52.50 $79.00 NC NC NC Rhode Island $65.02 $65.02 $33.00 $25.20 NC NC NC South Carolina $66.05 $62.60 $122.66 $185.76 NC NC NC South Dakota $76.58 $106.81 $143.86 $116.84 $17.45 $10.14 NL Texas $109.55 $109.55 $161.77 $80.48 $8.00 $8.00 $8.00 Utah $56.62 $53.46 $104.82 $166.72 $12.61 $7.46 $9.56 Vermont $79.66 $72.35 $147.49 $58.66 $51.29 $6.80 $6.00 Virginia $59.14 $55.78 $109.34 $96.81 * * * Washington $67.78 $44.28 $86.58 $78.84 $11.90 $6.37 $5.95 West Virginia $54.93 $51.97 $102.17 $82.78 NC NC NC Wisconsin $108.31 MP $92.48 $60.03 NA NA NA Wyoming $94.25 $88.99 $174.48 $277.50 $14.00 $14.00 $14.00

Source: 2007/8 AAP Medicaid Reimbursement Survey. Copyright 2008 American Academy of Pediatrics. * See abbreviations and (foot)notes, by state, at front and end of report.

5

State* Immunization Services 90468 90471 90472 90473 90474 90645-8 90649 90657 90658

Alabama NA NA NA NA NA NA NA NA NA Alaska $14.18 $28.43 $15.29 $19.06 $13.08 NA $142.50 NA NA Arizona NL $19.98 $10.73 $13.38 $9.18 $21.23 $127.24 $6.31 $12.62 Arkansas NC NC NC NC NC $9.56 $9.56 $9.56 $9.56 California $4.46 NC NC NC NC $25.00 $146.96 $13.76 $13.76 Colorado $6.50 $6.50 $6.50 $6.50 $6.50 VFC VFC VFC VFC Connecticut $4.91 $9.18 $5.30 $6.82 $4.71 $24.46 65% of cost $19.71 $10.50 Delaware $9.76 $19.73 $10.53 $13.15 $8.99 NA NA NA NA Dist of Columbia NA $4.28 $3.04 NA NA $35.00 PR $106.50 $40.00 Florida NC $5.00^ $5.00^ $5.00^ $5.00^ $10.00^ $10.00 ***^ $10.00^ $10.00^ Georgia NC NC NC NC NC $24.07 $8.00 $9.22 $8.00 Hawaii NL $4.00 $4.00 NL NL $4.00 $4.00 $4.00 $4.00 Idaho $9.48 $16.81 $10.13 $12.87 $9.15 $22.45 $131.73 $6.31 $12.62 Illinois NA ** ** ** ** NA $149.33*** $38.28*** $6.40 Indiana * * * * * $27.04 $150.00 $6.91 $13.81 Iowa NC $5.25 $5.25 $13.30 $7.09 $24.44 $150.00 $5.44 $9.55 Kansas $14.88 $14.15 $14.15 $14.15 $14.15 $0.01 $135.00 $0.01 $20.16 Kentucky NA NA NA NA NA $3.30 $3.30 $3.30 $3.30 Louisiana NC** $9.45 $9.45 NC** NC** NC NC NC NC Maine $5.10 $9.13 $5.49 $6.92 $4.92 NL $120.00 $9.95 $9.95 Maryland * * * * * $21.52 BI $6.03 $12.06 Massachusetts $7.86 $16.19 $8.51 $10.67 $7.21 NC BI $6.31 $12.62 Michigan $3.00 $7.00 $7.00 $3.00 $3.00 VFC VFC VFC $12.62 Minnesota $1.50 NL NL $1.50 $1.50 NL NL $6.60 $13.21 Mississippi $10.00 $10.00 $10.00 $10.00 NC NA $130.00 NA NA Missouri $5.09 $10.30 $5.49 $6.91 $4.70 $5.00 $5.00 $5.00 $5.00 Montana $14.13 $14.13 $14.13 $14.13 $14.13 NP $120.00 $5.65 $11.30 Nebraska NC $5.80 $5.80 $5.80 $5.80 VFC VFC VFC VFC Nevada NA $9.45 $9.45 $19.53 $19.53 $31.67 $256.28 $9.91 62% BC New Hampshire $3.00 $3.00 $5.00 $3.00 $5.00 $0.01 NA $5.38 $5.38 New Jersey $5.00 $11.50 $11.50 $5.00 $5.00 * $152.42 $9.10 $15.69 New Mexico NC NC NC $13.69 NC $10.94 $130.00 $10.94 $10.94 New York NL $2.00 $2.00 NL NL * * * * North Carolina $8.56 $17.25 $9.71 $11.60 $7.89 VFC VFC VFC VFC North Dakota $4.04 $8.77 $6.03 $5.93 $4.04 NA NA NA NA Ohio NC NC NC NC NC $21.52 $5.00 $5.00 $9.35 Oklahoma $13.33 $13.33 $13.33 $13.33 $13.33 $33.67 $132.00 $13.20 $12.50 Oregon $7.01 $12.72 $7.53 $9.60 NC $29.02 $120.00 $13.81 Pennsylvania NC NC NC NC NC $10.00 $10.00 $10.00 $10.00 Rhode Island NC NC NC NC NC NC NC NC NC South Carolina NC $13.00 $13.00 $3.00 $13.00 NC NC $3.71 $10.25 South Dakota NL $9.00 $9.00 $12.89 NL $9.00 $9.00 $11.00 $11.00 Texas $8.00 $8.00 $8.00 $8.00 VCP VCP $128.88 $5.65 $11.30 Utah $7.24 $7.80 $7.80 $7.80 $2.73 $9.14 $132.85 $13.46 $13.46 Vermont $6.00 $6.00 $6.00 $7.64 PAC 6* $21.76 PAC 6 $9.94 $9.94 Virginia * * * * * $39.89 $119.75 $13.00 $10.70 Washington $5.95 $11.90 $6.39 NC NC $5.96 $5.96 $5.96 $5.96 West Virginia NC $12.00 $12.00 NC NC VFC VFC VFC VFC Wisconsin NA $3.28 $3.28 NA NA VFC VFC VFC VFC Wyoming $14.00 $10.00 $10.00 $10.00 $10.00 BR BR BR BR Source: 2007/8 AAP Medicaid Reimbursement Survey. Copyright 2008 American Academy of Pediatrics. * See abbreviations and (foot)notes, by state, at front and end of report.

6

State* Immunization Services 90660 90669 90680 90700 90701 90702 90707 90713 90715

Alabama NA NA NA NA NA NA NA NA NA Alaska NA NA $79.69 NA NA NA NA NA NA Arizona $21.18 $73.42 $16.41 $31.70 $21.70 $21.54 $42.53 $26.25 $33.83 Arkansas $9.56 $9.56 $9.56 $9.56 $18.00* NC $9.56 $9.56 $9.56 California $22.27 $77.47 $44.30 $25.82 $21.26 $10.93 $38.27 $28.94 $45.79 Colorado VFC VFC VFC VFC VFC VFC VFC VFC VFC Connecticut $53.82 $10.55 MP $13.32 $104.00 $10.40 $37.40 $22.52 MP Delaware NA NA NA NA NA NA NA NA NA Dist of Columbia $55.20 $18.05 NA $13.25 $23.02 $2.73 $39.79 $26.05 NA Florida $28.98 $10.00^ $10.00^ $10.00^ $10.00^ $10.00^ $10.00^ $10.00^ $10.00^ Georgia NC $8.00 $8.00 $10.00 $18.48 $18.55 $10.00 $8.00 $10.00 Hawaii $4.00 $4.00 $4.00 $4.00 $4.00 $4.00 $4.00 $4.00 $4.00 Idaho $21.18 $58.75 $68.75 $29.03 $17.23 $18.30 $41.72 $25.79 $33.20 Illinois $6.40 $6.40 $6.40 $6.40 $6.40 $6.40 $6.40 $6.40 $38.28*** Indiana $22.44 $86.38 $48.25 $25.63 $10.12 $23.55 $55.49 $28.31 $46.23 Iowa $29.84 $67.15 $45.58 $17.69 $23.15 $2.66 $39.23 $22.01 $41.53 Kansas $16.31 $0.01 $0.01 $0.01 $18.57 $0.01 $46.98 $0.01 $76.78 Kentucky $3.30 $3.30 NA $3.30 $3.30 $3.30 $3.30 $3.30 $3.30 Louisiana NC NC NC NC NC NC NC NC NC Maine $48.00 $152.25 BR $17.76 $11.97 $3.92 $27.29 BR $36.00 Maryland $21.18 $58.75 $63.25 $30.46 NC $18.30 $38.51 $26.23 $35.50 Massachusetts $21.18 NC NC NC NC NC $41.72 $25.79 $33.20 Michigan $21.18 VFC NC VFC NC VFC VFC VFC VFC Minnesota $22.03 NL NL NL NL NL NL NL NL Mississippi $21.18 NA NA NA NA NA NA NA NA Missouri $5.00 $5.00 $5.00 $15.00 $19.00 $10.00 $15.00 $5.00 $15.00 Montana $18.75 NA $69.17 $29.03 NP $18.30 $41.72 $25.79 $33.20 Nebraska $11.22 VFC VFC VFC NC NC VFC VFC VFC Nevada $13.17 $22.98 62% BC $17.98 $39.52 $12.15 $46.85 $14.04 NA New Hampshire $57.50 $0.01 $48.00 $0.01 $2.00 $2.00 $0.01 $0.01 $26.99 New Jersey $24.94 $86.38 $81.38 $26.59 $16.34 $25.00 $52.29 $30.81 $45.54 New Mexico $21.18 $26.60 $10.00 $10.94 $29.93 $10.94 $10.94 $10.94 $33.83 New York * * * * * * * * * North Carolina VFC VFC VFC VFC VFC VFC VFC VFC VFC North Dakota NA NA NA NA NA NA NA NA NA Ohio $21.18 $5.00 $5.00 $5.00 NC $5.00 $41.71 $5.00 $35.75 Oklahoma $24.75 $72.50 NC $19.84 $16.00 $5.00 $32.00 $18.48 $38.83 Oregon $22.44 NP NP NP NP NP $58.41 $27.06 $43.50 Pennsylvania $10.00 $10.00 $10.00 $10.00 NC $10.00 $10.00 NC NC Rhode Island NC NC NC NC NC NC NC NC NC South Carolina NC NC NC NC NC NC NC NC NC South Dakota NL $9.00 $9.00 $9.00 $9.00 $9.00 $9.00 $9.00 $26.13 Texas VCP VCP $55.94 VCP VCP VCP VCP VCP VCP Utah $52.19 $68.80 $57.12 $7.79 $4.84 $15.77 $13.46 $7.26 $20.37 Vermont PAC 9* $80.46 PAC 6* $20.05 $16.67 $7.53 $34.93 $23.00 PAC 6* Virginia $19.95 $65.86 $63.25 $21.40 $12.00 $9.70 $40.37 $21.80 $35.75 Washington NC $5.96 $5.96 $5.96 $18.21 $5.96 $5.96 $5.96 $5.96 West Virginia NC VFC VFC VFC NC VFC VFC VFC VFC Wisconsin VFC VFC VFC VFC VFC VFC VFC VFC VFC Wyoming BR BR BR BR BR BR BR BR BR Source: 2007/8 AAP Medicaid Reimbursement Survey. Copyright 2008 American Academy of Pediatrics. * See abbreviations and (foot)notes, by state, at front and end of report.

7

State* Immunization Services Observation 90716 90718 90721 90723 90744 99217 99218 99219 99220

Alabama NA NA NA NA NA $51.00 $48.00 $81.00 $113.00 Alaska NA NA NA NA NA $97.21 $91.70 $151.70 $213.40 Arizona $73.96 $14.44 $42.89 $83.09 $24.36 $65.99 $62.22 $102.92 $144.79 Arkansas $9.56 $9.56 $9.56 $9.56 $9.56 $46.73 $52.80 $75.90 $116.60 California $48.94 $13.96 $35.13 $151.22 $27.20 $49.42 $48.00 $75.93 $95.35 Colorado VFC VFC $48.88 VFC VFC $37.49 $19.60 $79.24 $58.80 Connecticut $65.76 $9.62 $42.78 MP $71.12 $33.52 $31.76 $52.79 $74.22 Delaware NA NA NA NA NA $66.63 $62.77 $103.81 $146.06 Dist of Columbia $39.94 $1.60 $0.55 NA $26.42 $34.00 $37.00 $60.00 $78.41 Florida $10.00^ $10.00^ $10.00^ $10.00^ $10.00^ $37.78 $35.33 $58.20 $81.70 Georgia $8.00 $10.00 NC $10.00 $8.00 $57.41 $60.29 $98.89 $132.67 Hawaii $4.00 $4.00 $4.00 $4.00 $4.00 $50.53 NL NL NL Idaho $72.75 $18.95 $41.72 $75.33 $30.08 $64.58 $64.58 $107.83 $151.05 Illinois $46.60*** $6.40 $35.25*** $6.40 $6.40 ** $69.55 $69.55 $69.55 Indiana $93.01 $10.00 $52.86 $88.40 $24.20 $45.15 $49.31 $78.40 $99.52 Iowa $47.16 $6.57 $43.51 $78.81 $54.47 $64.04 $67.04 $110.10 $148.17 Kansas $80.94 $39.15 $46.27 $0.01 $0.01 $56.30 $63.99 $89.52 $125.75 Kentucky $3.30 $3.30 $3.30 $3.30 $3.30 $53.44 $51.39 $85.09 $119.51 Louisiana NC NC NC NC NC NC $42.68 $71.20 $99.70 Maine BR $3.92 $28.13 BR $8.50 $36.03 $34.41 $57.25 $80.43 Maryland $67.74 $18.47 $41.72 $60.06 $24.36 $57.34 $54.41 $90.46 $127.17 Massachusetts $72.75 NC NC NC NC $52.25 $50.01 $82.66 $116.34 Michigan VFC VFC VFC VFC VFC $40.26 $38.32 $63.73 $89.56 Minnesota NL NL NL NL NL $45.76 $49.80 $74.44 $103.22 Mississippi NA NA NA NA NA $60.30 $57.73 $96.06 $134.90 Missouri $5.00 $10.00 $20.00 $25.00 $5.00 $35.69 $33.70 $55.70 $78.50 Montana $72.75 $18.95 $41.72 $70.72 $26.91 $58.47 $55.97 $93.11 $130.78 Nebraska VFC VFC NC VFC VFC $33.03 $44.04 $78.91 $99.09 Nevada $80.69 $11.72 $32.99 $46.18 $31.67 $55.69 $55.69 $93.23 $130.46 New Hampshire $0.01 $2.00 $10.00 $41.00 $0.01 $33.60 $37.84 $60.02 $84.00 New Jersey $95.00 $12.50 $53.91 $87.46 $28.66 $20.60 NC NC NC New Mexico $10.94 $10.94 $10.94 $15.00 $10.94 $71.78 $68.60 $114.14 $160.32 New York * * * * * $5.00 $6.50 $6.50 $6.50 North Carolina VFC VFC VFC VFC VFC $60.36 $57.04 $94.30 $132.88 North Dakota NA NA NA NA NA $60.48 $57.53 $94.78 $133.87 Ohio $72.75 $13.75 $5.00 $5.00 $5.00 $31.70 $34.60 $55.79 $73.01 Oklahoma $75.00 $7.50 MP MP $42.00 $61.63 $58.39 $96.57 $136.06 Oregon $95.77 $22.50 NP NP NP $48.53 $46.19 $76.81 $107.95 Pennsylvania NC $10.00 $10.00 $10.00 $10.00 NC NC NC NC Rhode Island NC NC NC NC NC $34.47 $38.18 $60.89 $76.99 South Carolina NC NC NC NC $20.69 $57.24 $54.65 $90.92 $127.72 South Dakota $9.00 $9.00 $9.00 $9.00 $9.00 $54.34 $62.82 $94.28 $121.16 Texas VCP VCP NC VCP VCP $58.08 $58.24 $90.59 $122.95 Utah $62.99 $12.20 $15.31 $18.57 $30.42 $48.14 $46.87 $76.20 $107.09 Vermont $57.86 $14.99 $43.70 PAC 6* $27.05 $82.94 $78.98 $131.35 $184.60 Virginia $66.81 $17.50 $41.72 $70.72 $59.09 $52.16 $49.37 $81.73 $114.92 Washington $5.96 $5.96 NC $5.96 $5.96 $41.42 $38.99 $64.77 $90.98 West Virginia VFC VFC NC VFC VFC $48.43 $46.07 $76.48 $107.49 Wisconsin VFC VFC VFC VFC VFC $41.33 $60.03 $66.13 $75.70 Wyoming BR BR BR BR BR $86.98 $78.03 $129.76 $182.37 Source: 2007/8 AAP Medicaid Reimbursement Survey. Copyright 2008 American Academy of Pediatrics. * See abbreviations and (foot)notes, by state, at front and end of report.

8

State* Prolonged Physician Services Team Medical Conferences Tel. Care 99354 99355 99356 99357 99358 99359 99361 99362 99371

Alabama $71.00 $70.00 $65.00 $66.00 NC NC NC NC NC Alaska $134.67 $133.61 $123.40 $123.91 $139.24 $67.11 NC NC NC Arizona $91.40 $90.62 $83.68 $84.08 $94.38 $45.47 $41.00 $90.00 BR Arkansas $106.00 $55.64 $106.00 $55.00 NC NC NC NC NC California $57.06 $54.44 $46.04 $42.99 $50.00 NC NC NC NC Colorado $43.09 $19.54 $42.28 $19.07 NC NC NC NC NC Connecticut $74.70 $46.49 $42.90 NP NP NP NP NP NP Delaware $92.32 $91.60 $84.50 $84.84 $95.14 $45.87 NA NA NA Dist of Columbia $63.84 $59.31 $45.02 $45.23 PR PR NA NA NA Florida $51.26 $51.46 $46.97 $46.97 NC NC NC NC NC Georgia $90.61 $88.37 $79.12 $79.72 NC NC NC NC NC Hawaii $66.64 $66.34 NL NL $38.23 NL NL NL NL Idaho $118.02 $110.45 $86.47 $87.15 NA NA NA NA NA Illinois MP MP MP MP ** ** NC NC Match Indiana $46.85 $20.82 $46.85 $50.82 MP MP MP MP MP Iowa $100.26 $97.93 $88.11 $88.68 NC NC NC NC NC Kansas $78.80 $78.02 $72.45 $73.05 NL NL NL NL NL Kentucky $71.96 $70.67 $68.88 $67.00 NA NA NA NA NA Louisiana NC NC NC NC NC NC NC NC NC Maine $50.46 $49.97 $46.42 $46.74 NC NC NC NC NC Maryland $99.68 $92.86 $73.48 $74.06 NC NC NC $40.50 NC Massachusetts NC NC NC NC NC NC NC NC NC Michigan $56.41 $55.76 $51.67 $52.10 NC NC NC NC NC Minnesota $72.30 $36.15 $73.23 $36.61 NL NL $30.90 $51.50 NL Mississippi $84.38 $83.56 $77.79 $78.33 NC NC NC NC $11.25 Missouri $100.00 $55.00 $100.00 $55.00 NC NC $10.00 $25.00 NC Montana $81.76 $80.91 $75.36 $75.92 BD BD BD BD BD Nebraska $73.40 $36.70 $80.74 $40.37 NC NC NC NC $33.03 Nevada $103.69 $96.62 $74.46 $75.39 NA NA NA NA NA New Hampshire $60.48 $58.34 $56.00 $56.00 $37.74 NC $16.80 $33.60 $5.60 New Jersey $58.80 $29.40 $58.80 NC NC NC NC NC NC New Mexico $100.46 $99.39 $92.42 $93.14 NC NC $26.76 $53.52 NC New York $25.00 $12.50 $25.00 $12.50 NL NL NL NL NL North Carolina $83.62 $83.06 $76.95 $77.18 NC NC $31.71 $62.04 NC North Dakota $83.72 $83.35 $77.45 $77.45 NC NC NC NC NC Ohio NC NC NC NC NC NC NC NC NC Oklahoma $85.40 $84.94 $78.82 $78.97 $75.11 $75.11 NC $200.00 MP Oregon $67.99 $67.21 $62.28 $62.80 NC NC $26.46 $39.70 $10.82 Pennsylvania NC NC NC NC NC NC NC NC NC Rhode Island $35.71 $16.10 $35.71 $20.64 Varies NC $36.04 NC $20.00 South Carolina $80.18 NC $73.81 NC NC NC NC NC $4.75 South Dakota $75.34 $72.63 $85.80 $70.30 $56.89 NL NL NL NL Texas $60.51 $27.48 $60.51 $27.48 $93.90 $45.21 $52.86 $81.37 NC Utah $69.00 $66.68 $61.78 $62.30 $87.79 $43.76 $49.13 $86.11 $7.93 Vermont $96.88 $70.20 $88.91 $89.47 PAC 9* PAC 9* PAC 9* PAC 9* PAC 9* Virginia $72.25 $71.69 $66.39 $66.66 ** ** $25.87 $51.76 $12.28 Washington $57.28 $56.84 $52.65 $52.87 BO BO $46.48 $75.73 $7.49 West Virginia $67.03 $66.44 $61.72 $62.31 NC NC NP NC NC Wisconsin $86.80 $67.59 $88.09 $88.09 NC NC NC NC NC Wyoming $114.86 $113.54 $105.21 $106.09 $60.00 $30.00 $79.64 $115.48 $72.40 Source: 2007/8 AAP Medicaid Reimbursement Survey. Copyright 2008 American Academy of Pediatrics. * See abbreviations and (foot)notes, by state, at front and end of report.

9

State* Telephone Care Care Plan Oversight Hospital Care 99372 99373 99339 99340 99374 99375 99221 99222 99223

Alabama NC NC NC NC $26.00 $36.35 $49.00 $81.00 $113.00 Alaska NC NC $98.45 $136.79 $94.74 $165.77 $125.41 $175.77 $256.30 Arizona BR BR $66.85 $92.77 $64.35 $112.61 $84.95 $119.12 $173.58 Arkansas NC NC NC NC NC NC $64.90 $92.40 $141.90 California NC NC NC NC NC NC $37.42 $79.86 $87.39 Colorado NC NC NC NC NC NC $54.35 $88.37 $124.18 Connecticut NP NP NP NP NP NP $32.10 NP $74.07 Delaware NA NA $67.53 $93.79 $65.12 $114.19 $85.73 $120.29 $175.30 Dist of Columbia NA NA NA NA NA NA $34.00 $56.40 $78.45 Florida NC NC NC NC NC NC $51.26 $69.24 $102.53 Georgia NC NC NC NC NC NC $60.29 $99.20 $132.67 Hawaii NL NL NL NL NL NL $53.33 $87.63 $116.67 Idaho NA NA NA NA NA NA $65.28 $108.52 $151.54 Illinois Match NC NC NC ** NC $33.90 $51.40 $69.00 Indiana MP MP NC NC MP MP $48.49 $80.67 $103.60 Iowa NC NC NC NC NC NC $67.04 $110.44 $148.17 Kansas NL NL NL NL NL NL $54.31 $90.07 $125.52 Kentucky NA NA NA NA NA NA $51.66 $85.60 $119.25 Louisiana NC NC NC NC NC NC $43.12 $71.64 $99.87 Maine NC NC NC NC NC NC $37.87 $63.05 $80.30 Maryland NC NC NC NC NC NC $69.54 $97.62 $142.37 Massachusetts NC NC NC NC NC NC $68.14 $95.69 $139.52 Michigan NC NC NC NC NC NC $38.75 $64.16 $89.35 Minnesota NL NL NL NL NL NL $54.07 $100.42 $112.01 Mississippi NC NC NC NC NC NC $58.26 $96.63 $134.66 Missouri NC NC NC NC NC NC $46.14 $64.61 $94.30 Montana BD BD NP NP BD BD $56.53 $93.67 $130.49 Nebraska $33.03 $33.03 NC NC NC NC $91.75 $80.74 $104.60 Nevada NA NA NA NA $82.46 $105.85 $56.62 $93.85 $130.77 New Hampshire $11.20 $16.80 NC NC NC NC $62.72 $96.32 $112.00 New Jersey NC NC NC NC NC NC $25.00 $25.00 $25.00 New Mexico NC NC NC NC NC NC $69.31 $114.84 $159.97 New York NL NL NL NL NL NL $6.50 $6.50 $6.50 North Carolina NC NC NC NC NC $102.56 $62.06 $103.86 $144.76 North Dakota NC NC NC NC $58.64 $101.79 $78.92 $110.64 $161.53 Ohio NC NC NC NC NC NC $34.52 $55.71 $72.66 Oklahoma MP MP $62.12 $87.05 NC NC $80.62 $112.59 $164.77 Oregon $10.82 $10.82 MP MP $48.01 $86.93 $46.71 $77.33 $107.69 Pennsylvania NC NC NC NC NC NC $29.50 $29.50 $42.00 Rhode Island NC NC NC NC NC NC $38.18 $44.00 $46.00 South Carolina NC NC NC NC NC NC $55.07 $91.49 $127.60 South Dakota NL NL NL NL NL NL $67.47 $93.84 $121.22 Texas NC NC $65.73 $91.47 $58.78 $88.68 $66.43 $105.38 $133.20 Utah $19.60 $39.21 NC NC $44.67 $60.80 $47.41 $78.48 $109.30 Vermont PAC 9* PAC 9* PAC I* PAC I* PAC 9* PAC 9* $79.66 $78.98 $131.35 Virginia $58.23 $86.88 ** ** $50.49 $70.83 $70.02 $94.83 $140.02 Washington $14.76 $22.25 $41.86 $58.16 BO $70.06 $53.75 $75.21 $109.71 West Virginia NC NC NC NC $46.36 $80.32 $63.19 $88.29 $128.75 Wisconsin NC NC NC NC NC NC $60.03 $66.13 $75.70 Wyoming NC NC NC NC $81.10 NC $78.91 $130.64 $181.93 Source: 2007/8 AAP Medicaid Reimbursement Survey. Copyright 2008 American Academy of Pediatrics. * See abbreviations and (foot)notes, by state, at front and end of report.

10

State* Hospital Care Hospital Discharge Consultations 99231 99232 99233 99238 99239 99241 99242 99243 99244

Alabama $24.00 $40.00 $57.00 $51.00 NP $41.00 $64.00 $86.00 $121.00 Alaska $52.77 $94.07 $134.30 $96.71 $139.66 $70.85 $130.95 $179.72 $263.91 Arizona $35.76 $59.56 $85.04 $65.59 $94.67 $48.29 $89.21 $122.38 $179.38 Arkansas $34.50 $50.60 $68.20 $52.80 NP $53.50 $72.60 $101.20 $119.90 California $30.00 $41.24 $49.97 $41.02 NP $33.38 $51.50 $64.91 $88.81 Colorado $28.28 $45.84 $63.87 $54.15 $67.56 $36.99 $58.16 $82.71 $148.20 Connecticut $16.08 $24.86 $37.32 $33.56 NP $24.40 $44.28 $59.06 $83.07 Delaware $36.10 $64.35 $91.86 $66.30 $95.70 $48.86 $90.13 $123.67 $181.39 Dist of Columbia $16.92 $27.96 $39.71 NA NP $32.00 $46.36 $61.29 $86.98 Florida $21.03 $38.19 $54.53 $54.32 NP $27.56 $51.67 $70.66 $104.97 Georgia $30.80 $48.02 $67.47 NC NP $48.05 $78.78 $100.50 $139.12 Hawaii $27.32 $42.31 $59.39 $50.28 $65.64 $34.65 $70.83 $90.55 $124.60 Idaho $32.71 $53.87 $76.67 $66.47 $91.23 $46.21 $85.74 $114.16 $162.60 Illinois $16.40 $24.90 $35.05 $29.65 NP $32.15 $40.20 $51.30 $71.40 Indiana $24.86 $37.20 $51.86 $44.05 $62.86 $33.43 $52.93 $68.63 $96.82 Iowa $34.23 $53.53 $75.32 $63.79 $83.90 $51.98 $86.07 $110.14 $153.31 Kansas $27.18 $44.49 $63.26 $56.34 $76.84 $38.97 $71.61 $95.50 $135.41 Kentucky $25.89 $42.24 $60.07 $53.44 NP $36.55 $67.83 $90.43 $128.22 Louisiana $25.84 $42.50 $50.53 $43.73 $66.42 $67.50 $76.50 $90.00 $114.05 Maine $23.96 $31.78 $49.78 $36.09 $49.21 $27.76 $45.95 $61.28 $86.70 Maryland $29.24 $52.25 $74.60 $57.41 $78.26 $41.40 $75.28 $101.69 $148.88 Massachusetts $28.75 $51.26 $73.13 $53.04 $76.47 $39.55 $72.62 $99.61 $145.82 Michigan $19.38 $31.65 $45.00 $40.26 $54.90 $28.63 $52.32 $69.76 $98.39 Minnesota $30.12 $34.76 $92.70 $40.94 $59.84 $46.35 $60.25 $78.79 $113.55 Mississippi $29.15 $47.73 $67.86 $60.35 NP $41.37 $76.22 $101.65 $144.31 Missouri $27.50 $34.60 $49.44 $35.50 $51.34 $26.00 $48.08 $65.83 $96.84 Montana $28.25 $46.20 $65.72 $58.43 $79.70 $40.19 $74.08 $98.79 $140.07 Nebraska $27.53 $44.04 $73.40 $66.06 $110.10 $44.04 $62.39 $80.74 $102.76 Nevada $28.31 $46.46 $66.16 $57.23 $78.77 $41.23 $76.31 $100.93 $143.08 New Hampshire $24.64 $33.60 $47.04 $61.54 $53.36 $34.72 $47.04 $72.80 $87.36 New Jersey $20.60 $20.60 $20.60 $20.60 $20.60 $37.00 $54.40 $54.40 $77.90 New Mexico $34.65 $56.67 $80.58 $71.78 NP $49.83 $91.60 $122.14 $172.96 New York $5.00 $5.00 $5.00 $5.00 $5.00 $20.00 $20.00 $20.00 $20.00 North Carolina $31.35 $51.34 $72.97 $60.13 $87.05 $43.59 $80.69 $110.60 $157.18 North Dakota $33.19 $59.38 $84.82 $60.48 $87.41 $43.15 $80.03 $109.90 $163.01 Ohio $17.49 $26.45 $37.06 $31.62 $40.31 $24.07 $38.89 $50.14 $70.13 Oklahoma $33.66 $60.59 $86.59 $61.49 $89.16 $43.78 $81.34 $111.64 $165.70 Oregon $23.36 $38.15 $54.24 $48.53 NP $34.51 $63.06 $84.08 $118.59 Pennsylvania $17.00 $17.00 $17.00 $17.00 NP $30.00 $30.00 $30.00 $44.00 Rhode Island $17.00 $29.72 $34.88 $47.47 NP $25.59 $37.00 $37.00 $49.00 South Carolina $27.61 $45.30 $64.36 $57.40 NP $39.66 $72.74 $97.04 $137.78 South Dakota $34.39 $48.43 $64.81 $54.40 $74.27 $46.84 $69.54 $91.92 $130.68 Texas $35.13 $50.43 $67.82 $60.51 $79.99 $44.87 $70.25 $90.77 $127.28 Utah $23.70 $38.72 $55.04 $49.25 $65.65 $35.03 $63.99 $85.33 $120.36 Vermont $39.94 $65.42 $83.15 $47.02 NP $48.71 $88.99 $118.71 $168.03 Virginia $28.73 $52.16 $74.47 $51.88 $75.03 $37.65 $70.57 $96.51 $143.37 Washington $22.47 $40.31 $57.50 $41.20 NP $29.74 $55.08 $75.78 $111.69 West Virginia $26.28 $46.95 $67.33 $48.13 NP $34.25 $64.38 $88.29 $130.23 Wisconsin $20.42 $25.56 $40.02 $37.59 $77.64 $47.09 $57.53 $78.49 $98.09 Wyoming $39.45 $64.44 $91.62 $111.79 NP $58.30 $106.53 $142.04 $200.34 Source: 2007/8 AAP Medicaid Reimbursement Survey. Copyright 2008 American Academy of Pediatrics. * See abbreviations and (foot)notes, by state, at front and end of report.

11

State* Consultations Pathology and Laboratory 99245 99254 99255 81000 81002 86580 87081 87880

Alabama $157.00 $102.00 $140.00 $4.00 $3.00 $6.00 $9.00 $14.00 Alaska $327.65 $230.88 $287.63 $7.38 $5.95 $13.69 $9.26 $16.76 Arizona $222.76 $156.50 $195.12 $20.32 $17.68 $9.75 $9.26 $16.76 Arkansas $123.20 $119.90 $123.20 $4.52 $3.66 $8.80 $9.47 $12.87 California $111.50 $65.01 $86.25 $3.50 $2.83 $8.08 $7.31 $10.27 Colorado $142.69 $106.65 $144.68 $4.15 $3.36 $8.61 $8.70 $15.75 Connecticut $107.23 $67.02 $92.39 $4.21 NP $5.20 $8.80 $53.23 Delaware $225.16 $158.01 $196.92 NA NA $9.56 NA NA Dist of Columbia $112.69 $71.30 $98.08 $2.00 $2.00 $5.47 $4.00 $7.00 Florida $128.26 $94.77 $114.58 $3.00 $2.00 $3.54 $5.50 $11.50 Georgia $180.61 $123.04 $167.90 $3.99 $3.21 $8.13 $8.33 $15.08 Hawaii $161.44 $108.71 $148.14 $4.37 $3.54 $5.15 $9.16 $16.58 Idaho $210.98 $136.85 $188.71 $4.37 $3.54 $8.01 $6.81 $16.10 Illinois $92.80 $66.40 $87.10 $3.50 $2.60 $4.00 $5.80 $15.70 Indiana $130.47 $97.44 $132.11 $4.37 $3.54 $6.51 $9.16 $16.58 Iowa $199.35 $136.86 $186.92 $4.64 $3.76 $9.41 $8.58 $17.59 Kansas $175.41 $113.13 $155.96 $4.37 $3.01 $4.37 $7.35 $7.50 Kentucky $166.18 $107.50 $148.20 $4.47 $3.15 $6.95 $9.31 NA Louisiana $147.85 $112.50 $135.00 $3.71 $3.00 $6.06 $7.74 $16.58 Maine $112.32 $72.37 $101.06 $3.84 $3.42 $5.76 $5.40 $13.00 Maryland $184.60 $128.54 $160.40 NL NL NL NL NL Massachusetts $180.89 $125.89 $156.96 $3.59 $2.89 $7.90 $7.50 $12.97 Michigan $127.24 $80.74 $111.31 $2.88 $1.20 $5.81 $5.16 $14.26 Minnesota $135.18 $113.55 $135.18 $4.43 $3.57 $7.01 $8.47 $16.76 Mississippi $187.07 $121.29 $167.22 $3.99 $3.21 $7.65 $8.33 $15.08 Missouri $120.15 $84.93 $105.81 $3.30 $1.61 $5.50 $8.69 $16.76 Montana $181.57 $117.62 $162.15 $4.42 $3.57 $7.51 NP $16.75 Nebraska $139.46 $110.10 $146.80 $4.43 $3.57 $18.76 $9.26 $16.76 Nevada $185.24 $118.77 $163.39 $2.22 $1.79 $13.33 $4.64 $8.39 New Hampshire $114.24 $87.36 $114.24 $3.50 $2.83 $4.00 $6.38 $12.67 New Jersey $77.90 $77.90 $77.90 $1.20 $1.00 $4.00 $9.00 $12.00 New Mexico $224.04 $144.27 $198.90 $4.43 $3.57 $8.41 $9.26 $16.76 New York $20.00 $20.00 $20.00 $4.00 $2.00 $5.00 $5.20 $3.75 North Carolina $202.50 $130.50 $179.17 $4.43 $3.57 $8.09 $8.06 $16.01 North Dakota $202.10 $144.94 $180.34 $4.43 $3.57 $5.00 $7.94 $16.76 Ohio $92.99 $68.10 $92.32 $4.37 $3.26 $4.89 $9.16 $16.58 Oklahoma $205.43 $147.77 $183.44 $4.21 $3.12 $7.75 $8.80 $15.92 Oregon $153.36 $97.31 $134.16 $3.23 $2.62 $7.01 $6.78 $12.27 Pennsylvania $49.00 $49.00 $49.00 * * * * * Rhode Island $51.00 $54.00 $55.00 $2.66 $2.14 $5.16 $5.56 $10.06 South Carolina $178.42 $114.88 $158.37 $3.75 $3.03 $7.45 $7.87 $14.25 South Dakota $169.16 $130.51 $161.34 NL NL NL NL NL Texas $169.01 $128.33 $168.33 $4.37 $3.54 $7.36 $9.16 $16.58 Utah $155.65 $96.54 $133.09 $4.26 $3.49 $5.50 $3.59 $15.72 Vermont $217.34 $138.53 $190.98 $7.26 $4.15 $14.82 $9.48 $26.68 Virginia $175.16 $129.43 $156.48 $4.37 $3.54 $6.79 $9.16 $16.58 Washington $138.57 $98.47 $122.71 $3.68 $2.76 $5.51 $7.69 $13.91 West Virginia $161.82 $115.76 $144.40 $3.99 $2.96 $5.56 $8.33 $15.08 Wisconsin $99.08 $87.84 $98.09 $4.37 $4.37 $9.21 $9.16 $16.58 Wyoming $259.08 $164.39 $226.64 $3.57 $2.87 $11.84 $9.26 $16.76

Source: 2007/8 AAP Medicaid Reimbursement Survey. Copyright 2008 American Academy of Pediatrics. * See abbreviations and (foot)notes, by state, at front and end of report.

12

State* Mental Health Developmental Testing 90801 90804 90806 90808 90862 90887 96110 96111

Alabama $110.00 $47.00 $71.00 $106.00 $37.00 $36.00 $10.00 $103.00 Alaska $214.05 $91.04 $132.81 $196.45 $74.59 $119.59 $19.02 $193.98 Arizona $149.41 $63.56 $92.64 $137.02 $52.07 $83.56 $14.39 $136.05 Arkansas $99.66 $62.29 $96.94 $163.36 $44.00 $12.96 NC $69.72 California $73.29 $29.18 $46.44 $74.30 $23.22 NC $59.90 $67.97 Colorado $75.60 $39.19 $59.29 NC $31.56 $130.65 $37.44 $102.17 Connecticut $115.23 $54.19 $83.82 $88.20 $51.31 $60.17 $14.60 $122.63 Delaware $146.90 $62.45 $91.00 $134.57 $51.22 $82.15 $12.94 $132.78 Dist of Columbia $77.38 $33.41 $49.95 $74.47 $26.38 $25.00 $20.00 $39.00 Florida $88.84 $36.55 $49.43 $72.10 $32.47 $43.50 NC NC Georgia Varies Varies Varies Varies Varies NC NP $11.77 Hawaii $104.43 $46.62 $75.00 $110.09 $38.28 NL NL NL Idaho $145.70 $39.14 $58.72 $87.58 $51.27 $47.08 $28.67 $60.51 Illinois $67.50 $27.55 $47.50 $64.80 $64.80 NC $16.55 10.71 Indiana $80.90 $40.92 $63.67 $106.79 $37.23 $51.19 $7.32 $46.45 Iowa $133.71 $59.37 $90.96 $139.64 $48.41 NC $9.98 $124.25 Kansas $120.00 $30.00 $60.00 $90.00 $49.00 NL $31.50 $114.94 Kentucky $85.01 $42.33 $71.48 $42.23 $39.02 NA $32.19 $49.92 Louisiana NC NC NC NC NC NC NC NC Maine $82.28 $36.80 $73.60 $89.38 BR NC $58.38 BR Maryland $140.75 $46.50 $84.50 $84.50 $53.00 NC $12.50 $75.00 Massachusetts $117.89 $50.05 $72.79 $107.56 $41.16 $66.04 NC NC Michigan $86.77 $37.25 $55.98 $83.54 $29.50 $50.38 $7.75 $82.46 Minnesota $43.47 $35.91 $75.60 $96.39 $60.48 $39.31 $23.16 NL Mississippi $130.67 $56.02 $84.68 $126.32 $44.33 NC $38.87 $123.12 Missouri $78.59 $33.46 $66.00 NC $27.27 NC NC $71.38 Montana $128.58 $55.25 $83.23 $124.30 $43.71 NC $10.34 $119.72 Nebraska $155.74 $46.72 $93.73 $121.40 $38.94 $38.94 $26.92 $96.52 Nevada $176.57 $78.10 $117.14 $173.11 $62.48 NA $82.43 NA New Hampshire $65.00 $32.50 $65.00 $72.00 $26.18 $45.00 $5.00 $38.99 New Jersey $26.00** $13.00** $26.00** NC $14.00 $13.00** NC $26.00 New Mexico $141.00 $61.00 $91.00 $129.65 $75.00 NC $12.42 $12.42 New York $45.00 $27.00 $54.00 $81.00 $22.50 NL NL $150.00 North Carolina $133.58 $56.86 $82.94 $122.93 $55.48 NC $10.06 $120.20 North Dakota $133.87 $57.16 $83.35 $119.86 $46.47 $81.50 $9.59 $120.60 Ohio $65.38 $36.69 $57.10 $96.06 $30.14 NC $8.49 $42.51 Oklahoma $136.91 $58.28 $85.27 $126.47 $47.42 $75.95 $8.40 $122.39 Oregon $131.44 $85.72 $98.58 $164.30 $35.55 $89.00 $9.54 $99.39 Pennsylvania $26.25 $26.00 $39.00 $65.00 $15.00 NC NC $50.00 Rhode Island NC $31.17 $48.50 $81.73 $15.60 NC NC $38.80 South Carolina $124.61 $53.45 $80.56 $120.26 $42.36 $71.77 $7.46 $116.24 South Dakota $85.65 $31.16 $56.65 $75.00 $42.97 NL $5.00 $116.00 Texas $131.25 $51.27 $80.79 $113.41 $45.54 NC NC NC Utah $32.23 $45.56 $68.48 $102.18 $83.82 $48.64 $113.60* $113.60* Vermont $75.99 $34.00 $60.04 $90.80 $44.09 $49.39 $10.44 $111.07 Virginia $111.77 $47.59 $69.62 $103.07 $38.89 NA $9.79 $101.70 Washington $91.20 $38.77 $56.84 $56.84 $31.72 NC RVU based RVU Based West Virginia $105.13 $44.89 $65.56 $109.85 $36.32 BO $12.11 $98.33 Wisconsin $80.13 $40.06 $80.13 $120.19 $31.68 $80.13 $80.13 $80.13 Wyoming $176.67 $75.84 $113.98 $170.09 $60.06 NC $15.78 $167.90

Source: 2007/8 AAP Medicaid Reimbursement Survey. Copyright 2008 American Academy of Pediatrics. * See abbreviations and (foot)notes, by state, at front and end of report.

13

State* SUBSPECIALTY CARE CODES: Allergy/Immunology Cardiology 95004 95010 95015 95024 95115 95117 32020 92950 93303

Alabama $2.48 $11.46 $9.47 $4.00 $9.28 $11.78 NC $216.00 $149.00 Alaska $7.12 $25.21 $16.94 $9.88 $20.31 $25.27 $257.62 $424.84 $322.79 Arizona $5.07 $17.72 $11.90 $7.01 $14.42 $17.91 NL $298.49 $228.06 Arkansas $2.88 $11.02 $11.54 $4.19 $11.02 $14.16 $265.10 $189.20 $261.91 California $2.07 $10.58 $11.24 $3.05 $5.35 NC $94.56 $125.47 $152.65 Colorado $2.24 $6.22 $6.22 $3.42 $8.93 $12.35 $215.09 $84.00 $164.16 Connecticut $2.11 $9.02 $5.50 $3.09 $7.94 $10.09 $119.25 $152.50 $111.83 Delaware $4.97 $17.49 $11.69 $6.90 $14.19 $17.67 $176.10 $293.11 $224.29 Dist of Columbia $2.22 $12.00 $10.77 $3.24 $8.35 $10.61 $130.00 $115.00 $125.00 Florida $3.47 $9.19 $7.35 $4.49 $4.89 $5.92 $95.18 $149.30 $126.01 Georgia $3.50 $13.31 $13.94 $5.11 $13.41 $17.25 $203.58 $189.40 $66.71* Hawaii $3.37 $8.42 $8.42 $4.93 $12.97 $16.97 $180.76 $168.25 $187.44 Idaho $3.30 $21.34 $19.28 $5.02 $13.15 $16.94 $207.60 $201.71 $196.78 Illinois $1.70 $6.60 $6.95 $2.50 $6.50 $8.30 $224.70 $112.50 $98.10 Indiana $2.48 $7.20 $7.20 $3.77 $11.43 $17.90 $187.93 $169.73 $162.94 Iowa $3.57 $14.29 $14.96 $5.23 $13.78 $17.77 $223.82 $209.42 $209.65 Kansas $2.99 $13.79 $8.81 $4.38 $11.23 $14.27 NP $241.98 $200.00 Kentucky $2.82 $2.66 $6.12 $4.10 $10.54 $13.37 $105.55 $176.52 $166.87 Louisiana $3.22* $19.82* $17.93* $4.80* $12.43* $15.89* $200.06* $191.39* $185.50* Maine $3.11 $8.91 $5.67 $2.84 $7.29 $9.28 NP $155.21 $107.84 Maryland NL $15.60 $9.58 $5.28 $13.57 $17.25 $89.93 $151.37 $117.45 Massachusetts $4.11 $14.35 $9.48 $5.73 $11.79 $14.71 $139.18 $237.47 $184.25 Michigan $2.37 $10.33 $6.46 $3.44 $8.83 $11.20 $123.80 $108.51 $127.46 Minnesota $3.09 $6.79 $7.72 $4.63 $13.00 $16.45 $355.35 $106.60 $155.93 Mississippi $3.11 $14.52 $9.37 $4.54 $11.66 $14.81 $184.63 $256.64 $175.47 Missouri $2.59 $9.08 $6.09 $3.58 $7.36 $9.15 $118.80 $155.39 $117.47 Montana $3.05 $14.08 $9.09 $4.46 $11.39 $14.44 $180.39 $249.22 $171.10 Nebraska $2.57 $5.14 $5.87 $3.67 $5.28 $124.28 $135.79 $201.85 Nevada $4.78 $27.34 $24.73 $6.94 $17.79 $22.56 $367.38 $248.16 $256.41 New Hampshire $1.63 $6.80 $3.85 $2.81 $7.00 $11.62 $150.00 $107.00 $128.89 New Jersey $3.75 $13.51 $11.99 $5.50 $2.50 $2.50 $105.00 $32.00 $93.00 New Mexico $3.89 $17.62 $11.27 $5.65 $14.48 $18.36 $220.94 $308.38 $70.10 New York $0.50 $0.50 $0.75 $0.75 NL NL $20.00 $6.50 $90.00 North Carolina $4.21 $15.20 $10.22 $5.20 $12.07 $15.06 $157.81 $260.57 $194.63 North Dakota $4.06 $14.75 $9.96 $5.53 $11.43 $14.38 $158.22 $257.79 $189.19 Ohio $2.73 $8.37 $8.73 $3.89 $10.34 $14.85 $174.09 $156.12 $162.25 Oklahoma $4.04 $15.13 $10.26 $5.66 $11.64 $14.56 $158.85 $261.68 $191.25 Oregon $2.85 $12.46 $7.79 $4.15 $10.64 $13.49 $149.21 $214.87 $153.62 Pennsylvania $1.50 $4.00 $4.00 $5.00 $3.50 $7.00 $209.74 NC $158.00 Rhode Island $0.96 $0.96 $0.96 $0.96 $8.40 $8.40 $126.00 $129.60 $130.86 South Carolina $3.00 $14.16 $8.99 $4.44 $11.47 $14.64 $172.18 $246.75 $170.44 South Dakota $3.46 $8.56 $8.70 $5.12 $13.22 $16.88 $249.86 $287.27 $194.58 Texas $4.87 $12.89 $10.31 $6.30 $11.74 $14.89 $225.68 $154.37 $68.45 Utah $2.89 $12.35 $7.72 $4.11 $10.79 $13.38 $148.03 $213.16 $105.54 Vermont $1.67 $10.55 $9.50 $2.54 $7.37 $8.82 $49.99 $86.53 $149.56 Virginia $3.54 $12.78 $8.70 $4.89 $10.06 $12.51 $135.16 $218.37 $162.62 Washington $2.86 $10.57 $7.05 $3.97 $8.37 $10.35 $108.61 $178.22 $133.28 West Virginia $3.25 $11.81 $7.97 $4.43 $9.15 $11.52 $134.36 $206.42 $47.54* Wisconsin $2.15 $6.91 $7.19 $4.60 $3.69 $4.90 $284.36 $183.58 $208.47 Wyoming $4.82 $21.04 $13.15 $7.01 $17.97 $22.80 $252.07 $362.98 $259.52 Source: 2007/8 AAP Medicaid Reimbursement Survey. Copyright 2008 American Academy of Pediatrics. * See abbreviations and (foot)notes, by state, at front and end of report.

14

State* Cardiology Procedures 93307 93320 93501 93510 31500 36555 36568 36600 36620

Alabama $134.00 $71.00 $533.00 $1,132.00 $100.00 $234.00 $257.00 $23.00 $48.00 Alaska $285.90 $126.21 BR BR $155.51 $436.01 $1,340.96 $44.27 $74.03 Arizona $202.25 $89.38 $845.95 $1,744.66 $109.06 $306.10 $345.02 $31.10 $51.83 Arkansas $195.80 $129.00 $294.00 $356.00 $89.17 $366.74 $319.76 $39.00 $105.98 California $150.10 $76.57 $546.35 $1,038.99 $59.20 $86.50 $68.56 $12.66 $42.07 Colorado $132.72 $154.84 $604.74 $1,236.34 $48.41 $96.82 $68.12 $6.92 $41.50 Connecticut $102.54 $44.98 NP $882.79 $62.98 $188.69 NP $18.09 $29.89 Delaware $198.86 $87.78 $160.24 $244.80 $106.12 $302.52 $341.63 $30.64 $50.50 Dist of Columbia $117.00 $51.00 $477.00 $941.00 $66.00 $71.02 $210.73 NA $36.00 Florida $100.69 $44.73 $99.46 $142.96 $60.04 $69.64 $52.69 $17.16 $28.39 Georgia $53.28* $22.07* $182.61* $234.77* $106.50 $292.33 $341.47 $21.78 $53.60 Hawaii $175.94 $77.00 $719.33 $1,423.00 $93.64 $61.36 $74.05 $19.84 $47.24 Idaho $178.16 $78.15 $727.71 $1,472.18 $114.26 $303.47 $350.77 $27.23 $53.01 Illinois $91.00 $39.80 $371.00 $727.50 $55.50 $74.38 $55.01 NC $37.40 Indiana $152.26 $72.09 $624.69 $1,167.49 $98.01 $98.76 $72.04 $16.52 $51.94 Iowa $194.35 $84.86 $788.37 $1,545.18 $118.16 $288.45 $76.00 $23.67 $59.42 Kansas $200.00 $88.09 $743.23 $1,431.45 $92.39 $390.72 $271.56 $24.06 $11.03 Kentucky $157.16 $72.12 $654.96 $1,223.29 $102.35 $102.82 $75.58 $17.39 $54.85 Louisiana $168.41 $93.58 $688.46* $1,392.47* $109.20* $242.66 $276.87 $25.53* $65.70 Maine $97.74 $56.93 $402.34 $825.64 $59.15 $158.08 $175.82 $22.50 $54.00 Maryland $104.41 $52.00 $144.00 $125.32 $53.91 $157.44 $178.98 $14.29 $91.59 Massachusetts $163.66 $72.19 $127.75** $195.82** $83.81 $248.45 $282.66 $25.02 $39.88 Michigan $116.26 $51.03 $481.84 $994.04 $65.67 $184.30 $206.26 $17.87 $31.22 Minnesota $173.81 $76.16 $463.50 $463.50 $100.42 NL NL $36.30 $98.88 Mississippi $158.54 $69.39 $651.99 $1,334.53 $99.40 $259.24 $284.25 $25.42 $47.53 Missouri $121.00 $165.00 $447.95 $922.33 $57.41 $174.46 $201.04 $16.19 $33.00 Montana $154.76 $67.82 $637.66 $1,305.77 $96.72 NP $275.34 NP NP Nebraska $216.53 $102.76 $770.70 $1,504.70 $74.57 $64.62 $49.71 $19.88 $54.68 Nevada $233.85 $108.82 $962.30 $1,958.00 $199.37 $240.21 $176.56 $27.06 $91.68 New Hampshire $121.89 $57.00 $175.00 $900.00 $70.00 $83.11 $60.78 $5.00 $39.00 New Jersey $55.00 $18.00 $603.00 $1,022.00 $37.00 $146.00 $113.00 $8.00 $16.00 New Mexico $194.82 $85.40 $803.90 $1,649.87 $118.19 $314.22 $346.80 $30.74 $56.37 New York $90.00 $87.00 $140.00 $80.00 $20.00 $16.00 $112.00 $7.50 $7.50 North Carolina $171.88 $75.60 $704.16 $1,424.31 $96.72 $266.52 $298.14 $27.16 $45.97 North Dakota $166.33 $73.02 $713.26 $1,461.92 $97.73 $260.74 $289.51 $26.55 $46.47 Ohio $151.53 $66.43 $610.34 $1,175.83 $90.13 $225.03 $261.13 $19.93 $48.27 Oklahoma $168.16 $73.78 $2,152.00 $2,228.44 $99.88 $266.13 $295.19 $27.17 $47.17 Oregon $140.13 $61.50 $580.76 $1,198.11 NP $222.13 $248.60 $21.54 $37.63 Pennsylvania $142.75 $66.34 $140.00 $187.50 $72.00 $251.50 $289.57 $13.00 $53.58 Rhode Island $48.00 $48.00 $210.00 $235.20 $42.00 $184.11 $214.66 $11.95 $33.60 South Carolina $154.33 $67.40 $633.94 $1,301.07 $93.03 $253.71 $280.46 $24.66 $44.55 South Dakota $171.26 $75.14 $692.83 $1,511.71 $123.97 $294.64 NL $28.74 $85.99 Texas $50.12 $31.91 $697.72 $1,307.07 $108.83 $162.40 $162.40 $17.46 $58.72 Utah $107.98 $48.20 $463.40 $1,013.56 $80.32 $220.37 $246.63 $21.36 $37.32 Vermont $160.44 $76.15 $183.75 $400.13 $56.17 $42.35 $32.58 $12.05 $33.69 Virginia $143.59 $63.37 $595.39 $1,228.29 $82.13 $221.09 $246.38 $22.58 $39.15 Washington $117.64 $51.77 $99.14 $151.13 $66.31 $181.77 $203.34 $18.51 $31.72 West Virginia $34.25* $13.88* $118.12* $178.66* $80.32 $203.46 $224.72 $51.33 $38.09 Wisconsin $189.79 $83.25 $780.98 $1,606.09 $106.91 $314.97 $362.55 $24.02 $64.04 Wyoming $236.73 $192.01 $981.01 $2,024.01 $133.71 $375.25 $419.97 $36.39 $63.57 Source: 2007/8 AAP Medicaid Reimbursement Survey. Copyright 2008 American Academy of Pediatrics. * See abbreviations and (foot)notes, by state, at front and end of report.

15

State* Procedures 36510 36660 10120 12015 36400 36410 36415 36416 62270

Alabama $137.00 $58.00 $96.00 $185.00 $19.00 $14.00 $2.00 $2.50 $114.00 Alaska $236.27 $99.08 $185.38 $345.19 $36.79 $26.18 $3.00 NC $229.06 Arizona $166.31 $69.71 $130.49 $242.79 $25.85 $18.39 $3.00 $4.25 $160.96 Arkansas $89.00 $117.93 $63.73 $156.57 $14.16 $19.80 $3.00 NC $108.90 California $25.69 $31.65 $51.75 $112.81 $16.75 $10.80 NC NC $81.91 Colorado $25.94 $69.51 $27.66 $82.99 $13.83 $6.92 $3.00 $3.00 $34.58 Connecticut $113.32 NP $76.89 $141.95 $14.68 $10.48 $2.52 $13.63 $93.15 Delaware $164.23 $67.63 $128.37 $237.88 $25.31 $18.14 NA NA $158.92 Dist of Columbia $36.00 $36.50 $55.93 $132.58 $25.53 $11.52 $1.00 NA $99.73 Florida $46.57 $35.53 $67.40 $127.85 NC NC NC NC $76.59 Georgia $48.22 $61.41 $76.56 $187.79 $17.10 $16.80 NC NL $107.29 Hawaii $42.29 $53.88 $69.23 $168.88 $15.84 $15.59 $3.00 NL $99.37 Idaho $67.31 $67.28 $100.20 $241.11 $39.30 $24.20 $3.13 $3.13 $184.33 Illinois $25.20 $37.40 $39.05 $125.50 $16.65 $16.65 $8.20* NC $53.70 Indiana $39.94 $53.35 $46.55 $133.41 $7.52 $11.04 $3.00 $3.00 $51.49 Iowa $53.68 $68.53 $83.37 $204.97 $18.29 $18.04 $3.27 $3.27 $114.66 Kansas $144.35 $60.71 $101.36 $193.76 $20.38 $13.90 NP NP $120.29 Kentucky $37.03 $55.20 $48.47 $138.99 $6.73 $11.67 $8.45 $3.27 $53.66 Louisiana $63.52 $64.13* $94.50* $227.55* $36.38 $22.44* $2.65 $2.65 $170.42* Maine $93.94 NP $65.18 $124.37 $27.00 $27.00 $2.70 $2.70 $77.65 Maryland $85.84 $34.41 $113.80 $211.34 $15.00 $14.00 $1.50 $1.50 $168.25 Massachusetts $135.29 $53.37 $104.79 $192.08 $20.38 $14.84 NC NC $130.45 Michigan $109.59 $42.63 $75.79 $142.53 $14.86 NC NC NC $90.64 Minnesota $85.74 $112.01 $38.62 $135.18 $27.41 $20.46 $3.00 $3.00 $75.89 Mississippi $151.25 $63.79 $106.95 $205.80 $21.71 $14.69 $2.70 NC $126.36 Missouri $85.92 $52.80 $67.70 $126.41 $13.44 $9.50 NC NC $83.37 Montana $146.73 $62.27 $103.94 $200.21 $21.10 $14.24 $3.00 NC $122.51 Nebraska $49.71 $19.88 $64.62 $114.33 $19.88 $14.91 $3.67 NC $99.42 Nevada $118.76 $116.92 $105.84 $299.08 $30.77 $14.75 $6.76 $7.37 $105.23 New Hampshire $15.00 $25.00 $12.50 $45.00 $10.00 $10.00 NC $12.00 $37.00 New Jersey $12.00 $26.00 $16.00 $40.00 $11.00 $16.00 $1.80 $1.80 $16.00 New Mexico $184.59 $76.23 $129.77 $248.09 $26.07 $17.76 $3.12 NC $153.70 New York NP $20.00 $8.00 $20.00 $8.00 NL NL NL $18.00 North Carolina $143.44 $61.15 $113.06 $211.54 $22.55 $15.95 $3.00 NC $139.71 North Dakota $139.78 $61.59 $111.01 $209.48 $22.50 $15.49 $3.32 $7.38 $136.82 Ohio $132.46 $51.31 $50.40 $135.24 $19.10 $15.33 $3.00 $3.63 $130.83 Oklahoma $142.05 $62.07 $112.55 $212.27 $22.72 NC $2.85 MP $139.24 Oregon $132.09 $51.38 $91.34 $171.79 $17.91 $12.46 $3.00 $3.00 $109.25 Pennsylvania $42.50 $49.50 $30.50 $61.50 NC NC NC NC $42.00 Rhode Island $25.20 $50.40 $25.20 $42.00 $5.40 $49.75 $1.80 NC $25.20 South Carolina $148.57 $59.53 $103.53 $196.77 $20.68 $14.27 $2.55 $3.00 $123.71 South Dakota $172.16 $102.10 $120.27 $125.95 $24.32 $16.61 $4.60 $3.75 $143.53 Texas $73.54 $82.48 $65.87 $147.49 $21.19 $14.32 NC NC $56.99 Utah $134.06 $52.15 $92.70 $174.35 $18.17 $12.63 $3.39 $2.92 $110.87 Vermont $33.33 $12.05 $27.28 $66.78 $12.56 $19.95 $8.00 $4.00 $63.83 Virginia $119.11 $52.20 $94.36 $177.85 $19.04 $13.32 $4.00 $1.16 $116.12 Washington $98.03 $42.08 $77.33 $144.96 $15.42 $11.02 $2.49 $2.49 $95.39 West Virginia $109.85 $51.38 $88.29 $169.50 $18.01 $12.11 $3.00 NC $107.19 Wisconsin $97.42 $186.79 $41.22 $135.12 $33.87 $10.01 ** ** $58.70 Wyoming $223.14 $86.80 $154.31 $290.21 $30.25 $21.04 $7.24 $3.62 $184.56 Source: 2007/8 AAP Medicaid Reimbursement Survey. Copyright 2008 American Academy of Pediatrics. * See abbreviations and (foot)notes, by state, at front and end of report.

16

State* Moderate Sedation Emergency Care 99143 99144 99145 99148 99149 99150 99282 99283 99284

Alabama NC NC NC NC NC NC $21.00 $21.00 $66.00 Alaska $201.47 $222.39 $64.62 $192.60 $157.50 $70.92 $54.95 $89.09 $162.91 Arizona BR BR BR BR BR BR $37.24 $60.56 $103.41 Arkansas $128.99 $128.99 $32.25 $148.34 $128.99 $37.09 $35.00 $53.90 $71.50 California $42.14 $42.14 $21.07 $42.14 $42.14 $21.07 $24.38 $44.60 $68.35 Colorado MP MP MP MP MP MP $28.56 $52.33 $80.05 Connecticut MP NP MP MP MP MP $12.90 NP $45.19 Delaware NA NA NA NA NA NA $37.48 $60.81 $111.13 Dist of Columbia NA NA NA NA NA NA $17.42 $30.86 $48.17 Florida $55.49 $55.49 $27.74 $55.49 $55.49 $27.74 $22.92 $42.24 $64.68 Georgia NC NC NC NC NC NC $27.00 $54.80 $84.21 Hawaii NL NL NL NL NL NL $23.95 $48.05 $73.66 Idaho $42.34 $42.34 $42.34 $32.01 $32.01 $32.01 $26.43 $59.19 $92.51 Illinois $76.70 $76.70 $38.35 $38.35 $38.35 $19.17 $24.20 $32.20 $44.00 Indiana 90% BC MP MP MP NC MP $23.74 $43.82 $66.93 Iowa NC NC NC NC NC NC $29.90 $61.01 $93.93 Kansas NL NL NL NL NL NL $28.99 $55.23 $85.06 Kentucky NA NA NA NA NA NA $24.71 $47.40 $74.05 Louisiana $22.50 $22.50 $11.25 NC NC NC $19.80 $48.44 $75.68 Maine $8.00 $8.00 NC NC NC NC $19.42 $31.65 $49.43 Maryland $30.00 $30.00 $15.00 $30.00 $30.00 $15.00 $30.28 $63.48 $99.06 Massachusetts NC NC NC NC NC NC $29.63 $48.06 $87.79 Michigan NC NC NC NC NC NC $104.81* $104.81* $104.81* Minnesota NL NL NL NL NL NL $30.90 $37.46 $50.98 Mississippi NC NC NC NC NC NC $23.75 $53.38 $83.40 Missouri $31.17 $47.23 $11.72 $31.17 $47.23 $11.72 $20.23 $32.93 $60.01 Montana 47% BC 47% BC 47% BC 47% BC 47% BC 47% BC $23.10 $51.94 $81.14 Nebraska BR BR BR BR BR RNE $33.03 $49.55 $58.72 Nevada NA NA NA NA NA NA $22.77 $51.69 $80.31 New Hampshire NC NC NC NC NC $13.45 $24.64 $40.32 $60.48 New Jersey NC NC NC NC NC NC $20.60 $20.60 $25.00 New Mexico $62.81 $94.05 $23.35 $62.81 $94.05 $23.35 $28.26 $63.49 $99.17 New York $10.00 $10.00 $5.00 $10.00 $10.00 $5.00 $10.00 $10.00 $10.00 North Carolina NC NC NC NC NC NC $25.36 $55.56 $89.00 North Dakota NC NC NC NC NC NC $34.67 $56.06 $102.90 Ohio NC NC NC NC NC NC $18.12 $34.55 $53.21 Oklahoma $57.85 $86.26 $21.47 $57.85 $86.26 $21.47 $35.38 $56.87 $104.41 Oregon $81.73 $70.58 BR BR BR BR $18.94 $42.56 $66.40 Pennsylvania NC NC NC NC NC NC $26.85 $35.00 $50.00 Rhode Island NC NC NC NC NC NC $17.91 $38.00 $59.20 South Carolina $45.00 $45.00 $22.50 $91.57 $74.92 $33.30 $22.25 $50.00 NP South Dakota NL NL NL NL NL NL $29.83 $59.52 $89.92 Texas NC NC NC NC NC NC $45.56 $61.56 $90.07 Utah NC NC NC NC NC NC $18.79 $42.21 $65.90 Vermont PAC I* PAC I* PAC I* PAC I* PAC I* PAC I* $26.76 $60.12 $93.87 Virginia $69.74 $68.68 $57.24 $97.70 $95.04 $63.63 $26.60 $42.21 $77.60 Washington BO BO BO BO BO BO $23.57 $38.11 $69.84 West Virginia NC NC NC NC NC NC $28.05 $45.77 $83.57 Wisconsin NC NC NC NC NC NC $30.30 $40.54 $92.11 Wyoming 70% BC 70% BC 70% BC 70% BC 70% BC 70% BC $32.00 $71.89 $112.23 Source: 2007/8 AAP Medicaid Reimbursement Survey. Copyright 2008 American Academy of Pediatrics. * See abbreviations and (foot)notes, by state, at front and end of report.

17

State* Gastrointestinal Ophthalmology Otolaryngology 43239 44389 45331 67311 67314 68810 42820 42821 69436

Alabama $241.00 $273.00 $117.00 $412.00 $458.00 $155.00 $225.00 $248.00 $123.00 Alaska $476.03 $543.58 $234.39 $731.96 $815.15 $338.13 $398.77 $418.93 $228.64 Arizona $334.77 $382.47 $164.90 $513.02 $571.12 $237.13 $280.07 $294.40 $160.89 Arkansas $373.00 $268.40 $130.90 $652.74 $444.40 $172.57 $356.21 $422.00 $211.00 California $234.18 $180.94 $72.23 $521.22 BR $185.78 $168.65 $202.53 $120.63 Colorado $20.75 $10.37 $17.29 $484.12 $518.70 $53.94 $190.19 $207.48 $138.32 Connecticut $193.57 NP $95.57 $281.50 NP $124.51 $160.40 $173.66 $95.92 Delaware $330.12 $377.09 $162.88 $504.11 $561.30 $233.98 $274.36 $288.25 $237.97 Dist of Columbia $182.49 $209.98 $68.56 $273.00 $309.00 $85.92 $164.49 $171.44 $81.00 Florida $95.18 $102.12 $41.46 $279.82 $314.94 $127.24 $143.99 $150.93 $79.86 Georgia $210.98 $257.56 $102.19 $442.17 $493.57 $209.01 $240.77 $271.07 $130.29 Hawaii $193.87 $237.26 $94.04 $402.54 $448.96 $171.36 $217.62 $245.40 $158.37 Idaho $344.73 $383.90 $126.66 $474.46 $527.75 $158.48 $291.02 $315.33 $147.07 Illinois $249.70 $192.85 $142.70 $511.90 $511.90 $10.30 $194.20 $202.50 $80.50 Indiana $181.60 $200.11 $80.29 $403.96 $477.79 $50.29 $188.84 $226.09 $113.18 Iowa $227.87 $277.53 $110.15 $481.92 $538.31 $223.41 $262.79 $295.34 $141.64 Kansas $253.67 $288.14 $123.35 $384.30 $426.78 $163.49 $220.98 $239.65 $130.00 Kentucky $179.22 $210.07 $83.80 $412.47 $467.63 $51.50 $209.24 $236.90 $122.45 Louisiana $319.84* $356.65* $117.97* $514.99 $517.50 $147.79* $425.25 $425.25 $189.00 Maine $166.95 $185.73 $79.62 $357.22 $384.55 NP $156.00 $189.00 $105.59 Maryland $286.17 $325.96 $140.93 $281.00 $288.55 $121.29 $239.18 $259.01 $178.20 Massachusetts $270.59 $309.24 $134.10 $407.18 $453.26 $191.06 $220.85 $232.01 $127.64 Michigan $189.89 $216.16 $93.01 $280.97 $311.54 $122.08 $161.69 $175.25 $95.81 Minnesota $325.99 $280.16 $122.82 $596.37 NL NL $352.26 $374.66 $193.12 Mississippi $267.28 $303.42 $129.58 $408.43 $453.76 $172.29 $235.09 $235.04 $137.55 Missouri $173.40 $198.09 $185.00 $268.06 $298.57 $123.46 $211.75 $237.05 $176.75 Montana $259.36 $294.57 $125.70 $396.08 $439.92 $166.94 $228.52 $248.01 $133.64 Nebraska $213.75 $243.58 $89.48 $894.78 $894.78 $99.42 $303.23 $328.09 $198.84 Nevada $268.92 $305.84 $110.77 $838.16 $931.09 $181.54 $519.38 $562.46 $262.76 New Hampshire $126.00 $75.00 $85.00 $335.00 $424.00 $42.93 $179.00 $215.00 $100.00 New Jersey $142.00 $97.00 $47.00 $236.00 $223.40 $17.00 $68.00 $89.00 $47.00 New Mexico $324.28 $368.53 $157.68 $490.58 $544.62 $208.70 $282.70 $306.66 $165.94 New York $100.00 $150.00 $33.00 $240.00 $240.00 $12.00 $60.00 $80.00 $100.00 North Carolina $290.07 $331.05 $142.36 $451.80 $503.57 $207.76 $245.28 $257.50 $139.76 North Dakota $283.98 $323.44 $138.67 $448.83 $500.46 $204.68 $243.78 $255.95 $137.93 Ohio $172.53 $198.19 $88.43 $370.61 $468.90 $51.58 $185.55 $225.21 $108.17 Oklahoma $288.74 $329.04 $141.21 $457.13 $510.02 $208.68 $247.42 $259.41 $139.91 Oregon $228.88 $260.54 $112.10 $338.65 $375.50 $147.14 $194.88 $211.23 $115.48 Pennsylvania $211.50 $300.00 $85.00 $469.41 $483.50 NC $184.00 $199.00 $98.50 Rhode Island $184.80 $101.76 $65.84 $332.10 $369.60 $38.18 $117.60 $151.20 $84.00 South Carolina $260.07 $295.26 $126.79 $392.34 $435.86 $168.05 $224.49 $243.28 $131.71 South Dakota $302.05 $357.95 $147.08 $630.10 $694.04 NL $325.02 $399.94 $202.90 Texas $218.23 $226.39 $90.28 $719.39 $772.67 $50.46 $212.79 $256.33 $128.88 Utah $232.30 $258.47 $111.21 $343.71 $381.11 $149.33 $197.80 $214.39 $117.20 Vermont $160.77 $151.64 $60.73 $453.95 $463.47 $48.87 $192.58 $179.73 $123.54 Virginia $241.48 $275.48 $118.29 $378.27 $421.51 $172.68 $206.40 $216.74 $117.47 Washington $198.27 $226.03 $97.37 $308.86 $344.33 $141.87 $168.09 $176.46 $95.83 West Virginia $115.17** $125.50** $108.97 $356.72 $397.18 $124.62 $196.97 $207.01 $111.62 Wisconsin $481.90 $352.11 $106.45 $797.91 $797.46 $81.23 $265.42 $265.42 $212.13 Wyoming $386.65 $440.14 $189.38 $572.09 $634.34 $248.56 $329.22 $356.84 $195.08 Source: 2007/8 AAP Medicaid Reimbursement Survey. Copyright 2008 American Academy of Pediatrics. * See abbreviations and (foot)notes, by state, at front and end of report.

18

State* Critical Care Intensive Low Birth Weight Service 99291 99292 99293 99294 99295 99296 99298 99299 99300

Alabama $126.00 $63.00 $196.00 $131.00 $225.00 $132.00 $125.00 $89.00 $124.48 Alaska $376.83 $168.82 $1,114.60 $551.74 $1,278.87 $551.78 $196.12 $181.28 $174.59 Arizona $255.93 $114.60 $758.09 $374.66 $869.08 $374.00 $133.28 $123.23 $118.67 Arkansas $167.20 $83.60 $679.90 $336.37 $712.86 $334.62 $149.64 $111.50 $203.04 California $132.67 $64.26 NC NC NC NC NC NC NC Colorado $163.66 $71.90 $556.14 $302.09 $560.11 $469.14 $100.66 $100.04 $90.75 Connecticut $123.01 $54.03 $387.71 $192.79 $443.73 $193.57 $68.55 $62.69 $94.30 Delaware $85.73 $120.23 $761.62 $377.15 $874.60 $377.47 $134.14 $124.02 $119.47 Dist of Columbia $108.73 $55.91 $427.67 $204.92 $466.86 $206.00 $97.54 $68.13 $73.00 Florida $143.17 $65.36 $424.21 $208.23 $491.42 $206.70 $73.52 $70.05 $67.19 Georgia $163.48 $81.55 $690.72 $342.03 $683.12 $341.09 $118.51 $113.54 $111.75 Hawaii $144.08 $71.82 $144.08 $144.08 $300.00 $100.00 $75.00 $75.00 NL Idaho $209.25 $108.24 $756.63 $376.24 $771.08 $394.07 $138.73 $123.93 $159.85 Illinois $84.90 $42.35 $497.21 $245.39 $416.90 $206.90 $86.56 $81.22 $75.88 Indiana $142.35 $69.31 $587.12 $292.81 $673.60 $394.51 $105.87 $96.94 $91.25 Iowa $182.22 $90.86 $764.81 $382.36 $764.81 $382.36 $138.48 $126.48 $121.82 Kansas $201.60 $90.31 $659.91 $328.20 $756.28 $329.21 $120.00 $120.00 $153.22 Kentucky $157.68 $79.04 $629.04 $312.61 $644.30 $301.83 $110.47 $139.59 $101.02 Louisiana $150.30 $86.40 $761.54 $376.19 $496.85 $279.52 $100.10 $124.33 $99.14 Maine $129.18 $63.63 $420.59 $209.53 $482.35 $210.39 $74.06 $67.77 $65.67 Maryland $212.05 $94.22 $665.05 $344.99 $761.25 $345.28 $117.47 $113.68 $162.28 Massachusetts $207.86 $92.35 $603.47 $299.36 $693.09 BR $106.57 $98.60 $95.02 Michigan $145.97 $64.81 $470.65 $233.60 $538.47 $233.82 $82.89 $75.79 $72.99 Minnesota $123.60 $62.83 NL NL NL NL NL NL NL Mississippi $215.09 $96.68 $708.84 $352.57 $812.44 $353.38 $124.60 $113.82 $109.59 Missouri $165.00 $82.50 $410.41 $203.19 $660.00 $369.22 $72.10 $66.73 $64.26 Montana $208.57 $93.80 $689.34 $342.24 $789.34 $342.24 $121.04 $110.57 $106.47 Nebraska $154.14 $77.07 $477.10 $238.55 $550.50 $293.60 $126.25 $73.40 $73.40 Nevada NA NA $684.94 $338.16 $665.56 $338.47 $119.70 $112.31 $105.95 New Hampshire $80.64 $40.32 $456.96 $221.76 $456.96 $221.76 $93.17 $221.76 $119.89 New Jersey $58.80 $29.40 $369.90 $169.10 $369.90 $169.10 $58.80 $51.00 $51.00 New Mexico $257.31 $115.27 $924.14 $458.94 $1,058.14 $459.28 $162.44 $148.44 $142.92 New York $25.00 $12.50 $206.00 $114.00 $233.00 $115.00 $57.00 $54.00 $50.00 North Carolina $233.56 $104.28 $691.47 $343.42 $794.57 $344.46 $121.66 $112.52 $108.39 North Dakota $233.45 $105.11 $696.66 $346.30 $800.66 $347.04 $122.44 $113.22 $108.80 Ohio $95.19 $46.32 $258.13 $127.73 $271.81 $139.55 $45.36 $45.25 $69.41 Oklahoma $237.58 $106.99 $705.88 $351.56 $812.37 $353.60 $124.25 $114.80 $110.60 Oregon $175.94 $78.11 $51.38 $281.56 $649.01 $281.82 $99.91 $91.34 $87.97 Pennsylvania $151.63 $74.40 $621.87 $308.34 $703.91 $309.43 $108.56 $101.83 $94.44 Rhode Island $29.72 $17.00 $450.57 $222.91 $447.27 $221.47 NC $73.89 $116.41 South Carolina $126.00 $63.00 $665.90 $332.42 $764.42 $334.80 $117.50 $107.30 $103.38 South Dakota $376.83 $168.82 $680.75 $356.05 $722.68 $380.83 $166.41 $122.31 $167.95 Texas $255.93 $114.60 $759.19 $375.59 $869.77 $377.68 $159.38 $127.50 $124.50 Utah $167.20 $83.60 $562.77 $279.32 $643.87 $279.58 $99.11 $92.70 $148.54 Vermont $132.67 $64.26 $802.04 $399.98 $919.91 $402.58 $141.65 $129.41 PAC I* Virginia $163.66 $71.90 $601.93 $297.90 $690.92 $297.62 $105.71 $97.63 $94.00 Washington $123.01 $54.03 $474.53 $235.28 $545.02 $235.72 $83.49 $77.11 $74.24 West Virginia $85.73 $120.23 $571.70 $280.83 $653.50 $277.88 $99.52 $92.13 $88.59 Wisconsin $108.73 $55.91 $723.84 $360.29 $502.64 $351.86 $127.41 $116.69 $112.20 Wyoming $143.17 $65.36 $958.30 $475.64 $1,096.39 $476.08 $168.78 $156.31 $148.61 Source: 2007/8 AAP Medicaid Reimbursement Survey. Copyright 2008 American Academy of Pediatrics. * See abbreviations and (foot)notes, by state, at front and end of report.

19

State* Plastic Surgery Pulmonology 40700 42200 31622 32000 94010 94640 94644 94645 94664

Alabama $645.00 $658.00 $236.00 NC $24.00 $9.00 $23.00 $9.00 $10.00 Alaska $1,260.40 $1,229.94 $456.20 $239.90 $48.19 $18.66 $51.74 $19.76 $20.22 Arizona $884.57 $865.81 $320.64 NL $34.01 $13.25 $36.55 $14.03 $14.46 Arkansas $853.60 $1,188.00 $282.70 $119.90 $37.77 $14.16 $44.58 $17.07 $13.90 California $674.61 $674.61 $164.93 $82.65 $24.60 $12.76 NC NC $9.38 Colorado $553.28 $553.28 $172.90 $41.50 $30.80 $12.60 $25.62 $9.74 $23.80 Connecticut $484.99 $500.70 $189.66 NP $16.52 $6.18 NP NP $6.67 Delaware $866.38 $846.01 $316.41 $166.33 $33.53 $13.03 $36.23 $13.81 $14.09 Dist of Columbia $464.52 $446.81 $124.61 $93.71 $21.75 $14.73 $23.06 $8.75 $11.19 Florida $495.09 $448.11 $79.04 $80.06 $18.99 $7.75 $19.19 $7.35 $8.98 Georgia $721.51 $675.92 $196.25 $116.74 $11.36* $17.25 NC NC $16.90 Hawaii $647.11 $605.76 $179.32 $107.14 $24.25 $14.04 NL NL $14.65 Idaho $873.92 $807.06 $234.45 $166.14 $35.25 $25.92 $29.67 $11.18 $18.85 Illinois $718.70 $718.70 $291.90* $105.40* $45.05* $14.50 $17.87 $6.92 $15.20 Indiana $581.64 $469.81 $177.84 $68.48 $23.11 $10.54 $24.12 $9.10 $13.80 Iowa $790.33 $739.77 $213.19 $126.41 $27.14 $17.77 $30.74 $11.64 $17.35 Kansas $674.95 $688.85 $248.27 NP $29.82 $10.00 $21.99 $8.42 $17.14 Kentucky $611.31 $491.68 $53.30 $71.27 $24.44 $11.19 $23.85 NA $14.38 Louisiana $826.94* $889.06 $219.06* $154.31* $43.99 $24.08* $24.29 $9.38 $17.86 Maine $432.24 $441.03 $160.22 NC $28.44 $15.52 $16.64 $6.31 $6.11 Maryland $724.40 $746.60 NL $86.59 $17.52 $6.90 $15.34 $5.85 $7.46 Massachusetts $696.14 $679.83 $259.49 $136.36 $27.66 $10.82 NC NC $11.57 Michigan $491.31 $505.74 $185.80 $100.76 $18.73 $6.89 $20.24 $7.75 NC Minnesota $1,027.42 $1,011.20 $355.35 $100.42 $23.36 $15.02 NL NL $18.78 Mississippi $719.36 $732.92 $261.50 $142.07 $25.71 $9.08 $25.52 $9.72 $9.86 Missouri $462.06 $450.81 $166.18 $87.51 $17.46 $12.10 $18.72 $7.16 $27.00 Montana $699.15 $714.31 $253.56 $137.64 $25.03 $8.89 $26.08 $10.01 $9.78 Nebraska $795.36 $805.30 $233.64 $99.42 $38.54 $16.52 $22.02 $11.01 $31.20 Nevada $1,555.72 $1,439.40 $259.08 $132.92 $45.99 $34.28 $42.67 $16.35 $25.59 New Hampshire $400.00 $500.00 $138.00 $49.00 $18.00 $10.00 NC NC $6.00 New Jersey $263.00 $176.00 $96.00 $16.00 $18.00 NC $16.07 $6.12 $7.35 New Mexico $863.17 $883.38 $317.16 $172.14 NP $11.30 $30.05 $11.50 $30.05 New York $280.00 $240.00 $60.00 $12.00 $15.00 $3.00 NL NL $3.00 North Carolina $776.81 $470.92 $278.32 $146.79 $48.30 $11.08 $30.99 $11.74 $23.86 North Dakota $773.74 $747.93 $272.54 $143.83 $28.03 $10.70 NC NC $11.43 Ohio $585.65 $516.28 $157.12 $124.82 $21.89 $10.89 $23.12 $8.93 $9.38 Oklahoma $785.71 $756.35 $277.35 $146.60 $28.50 $10.67 $30.13 $11.31 $11.28 Oregon $592.18 $609.57 $223.95 $121.45 $22.58 $8.30 $24.39 $9.34 $9.08 Pennsylvania $568.50 $531.00 $166.00 $67.00 $15.00 NC NC NC $11.82 Rhode Island $369.60 $367.60 $117.60 $25.20 $18.00 $6.00 $19.40 $7.43 $10.80 South Carolina $685.19 $696.59 $254.94 $138.65 $25.13 $8.88 $25.40 $9.54 $9.43 South Dakota $1,200.00 $1,200.00 $313.46 $161.06 $29.07 $10.98 NL NL $11.46 Texas $870.16 $1,065.75 $202.20 $76.18 $25.37 $12.60 $25.64 $9.82 NC Utah $587.48 $604.74 $227.30 $123.25 $16.85 $8.42 $24.19 $9.26 $9.01 Vermont $494.30 $499.90 $144.56 $33.33 $29.90 $10.41 PAC 9* PAC 9* PAC 9* Virginia $654.01 $636.34 $231.42 $121.83 $24.20 $9.25 $25.57 $9.79 $10.06 Washington $532.24 $516.60 $190.12 $100.02 $19.83 $7.49 NC NC $8.15 West Virginia $624.56 $613.04 $214.09 $112.51 $22.44 $8.56 $23.03 $8.86 $9.74 Wisconsin $1,044.21 $1,044.21 $332.74 $89.65 $41.46 $15.72 $27.92 $10.64 $16.82 Wyoming $1,000.39 $1,029.76 $378.32 $205.16 $28.06 $14.03 $33.30 $12.31 $15.34

Source: 2007/8 AAP Medicaid Reimbursement Survey. Copyright 2008 American Academy of Pediatrics. * See abbreviations and (foot)notes, by state, at front and end of report.

20

State* Radiology Surgery Nephrology 71010 28262 44950 49500 49505 50200 90918 90919 90920 90945

Alabama $5.33 $890.00 $445.00 $285.00 $356.00 $132.00 $375.00 $316.00 $258.00 $54.00 Alaska $38.22 $1,770.47 $834.43 $506.85 $660.39 $209.93 $901.60 $654.87 $573.05 $103.37 Arizona $26.98 $1,251.08 $588.60 $357.43 $466.06 $147.16 $630.30 $457.71 $400.51 $72.26 Arkansas $28.60 $871.20 $536.80 $492.00 $539.90 $210.10 NC NC NC $81.40 California $17.30 $649.29 $400.59 $260.61 $344.01 $70.74 $305.70 $293.59 $293.59 $72.16 Colorado $13.44 $726.18 $345.80 $242.06 $293.93 $138.32 $156.60 $156.60 $156.60 $22.82 Connecticut $16.42 $678.64 NP $195.26 $258.46 $85.86 NP NP NP $70.28 Delaware $8.86 $1,217.04 $570.70 $347.53 $452.16 $967.83 $619.19 $449.22 $393.37 $70.99 Dist. Columbia $15.00 $685.50 $292.17 $199.00 $243.57 $103.00 $367.74 $248.24 $218.54 $90.49 Florida $12.45 $719.35 $324.75 $206.08 $261.43 $79.04 $330.87 $241.83 $208.73 $38.39 Georgia $8.15* $974.90 $458.73 $294.45 $363.81 $144.54 NC NC NC NC Hawaii $22.95 $879.70 $408.32 $266.17 $325.62 $129.47 NL NL $294.07 $63.76 Idaho $24.40 $1,178.08 $576.02 $334.88 $456.17 $134.27 $616.67 $481.80 $415.52 $79.57 Illinois $17.00 $524.40 $374.55 $362.00 $387.05 $112.40 $252.35 $213.65 $213.65 $36.50 Indiana $19.62 $679.00 $314.84 $269.72 $307.05 $146.18 MP MP MP $67.80 Iowa $25.84 $1,061.49 $503.19 $320.33 $397.77 $158.84 $540.89 $428.12 $371.05 $78.06 Kansas $23.85 $931.93 $463.54 $274.49 $365.89 $122.05 $234.63 $200.00 $200.00 $78.59 Kentucky $20.47 $712.14 $443.78 $286.06 $350.04 $152.50 $390.20 $312.74 $275.47 $73.57 Louisiana $19.68 $1,134.11* $551.82* $369.86 $435.80* $142.25 $577.57 $451.24 $388.73* $83.79 Maine BR $594.83 $297.19 $223.01 $293.89 $78.14 $338.97 $247.19 $208.23 $66.57 Maryland $14.65 $1,248.10 $488.22 $292.35 $387.49 $73.65 NC NC NC $36.26 Massachusetts $21.76 $974.62 $451.85 $276.88 $358.87 $115.11 $497.41 $359.90 $315.68 $57.04 Michigan $15.93 $688.74 $336.30 $300.35 $399.50 $87.84 $380.00 $276.23 $242.21 $43.28 Minnesota $29.35 $1,070.68 $610.27 $482.81 $602.55 $266.51 $483.89 $388.54 $342.68 $115.87 Mississippi $22.04 $991.92 $496.62 $293.34 $391.55 $130.56 $571.45 $392.60 $343.86 $64.39 Missouri $13.88 $649.46 $307.15 $242.00 $242.98 $77.20 $60.00 $60.00 $60.00 $37.90 Montana $21.46 $971.87 NP $286.92 $383.42 $126.75 $546.58 $399.53 $349.13 $62.31 Nebraska $32.40 $994.20 $571.67 $516.98 $487.16 $139.19 $587.20 $440.40 $367.00 $170.28 Nevada $32.58 $2,108.96 $1,023.40 $595.69 $782.17 $233.22 $752.31 $589.18 $508.05 $98.05 New Hampshire $10.00 $300.00 $284.00 $225.00 $273.00 $60.00 $160.00 $160.00 $160.00 $30.00 New Jersey $6.40 $184.00 $184.00 $158.00 $158.00 $26.00 $160.00 $160.00 $160.00 $30.00 New Mexico NP $121.03 $596.66 $353.07 $471.06 $155.88 $502.33 $397.77 $344.90 $76.71 New York $10.00 $120.00 $160.00 $140.00 $140.00 $20.00 $52.00 $52.00 $52.00 $75.00 North Carolina $23.04 $1,076.86 $511.37 $310.15 $404.10 $130.12 $560.50 $407.53 $356.49 $64.22 North Dakota $22.50 NP $512.63 $309.42 $404.20 $1,068.04 $560.58 $408.63 $357.00 $64.17 Ohio $20.72 $739.10 $353.21 $257.64 $298.75 $131.02 $315.02 $250.93 $219.52 $57.48 Oklahoma $22.71 $1,073.31 $515.05 $311.53 $405.99 $132.32 NC NC NC NC Oregon $19.20 $830.14 $405.34 $241.34 $321.00 $105.88 $458.02 $332.94 $291.94 $52.16 Pennsylvania $19.00 $569.50 $301.50 $318.50 $317.50 $138.00 NC NC NC NC Rhode Island $14.10 $436.80 $248.30 $227.25 $241.28 $42.00 $117.00 $117.00 $117.00 $38.60 South Carolina $21.43 $933.09 $462.70 $274.97 $365.44 $123.86 $540.40 $393.81 $344.95 $61.59 South Dakota $24.84 $810.34 $591.45 $413.30 $558.67 $182.11 $110.30 NL NL $75.30 Texas $8.02 $1,008.70 $455.38 $346.37 $366.59 $157.11 $329.77 $310.13 $266.21 $65.58 Utah $11.50 $823.56 $402.12 $244.94 $325.80 $105.03 $367.66 $293.31 $256.88 $51.75 Vermont $22.82 $617.96 $346.33 $247.10 $274.86 $123.54 $242.93 $242.93 $242.93 $39.28 Virginia $19.31 $915.89 $437.28 $264.05 $345.09 $109.59 $487.97 $332.13 $291.65 $53.84 Washington $15.86 $740.43 $352.03 $213.25 $278.02 $89.00 $383.10 $278.90 $243.87 $43.84 West Virginia $18.01 $814.14** $433.50 $256.91 $341.37 $105.13 $443.54 $324.24 $282.60 $50.79 Wisconsin $27.71 $895.03 $533.73 $698.49 $698.49 $184.88 OM OM OM OM Wyoming $26.47 $1,402.38 $684.75 $407.70 $542.28 $178.86 $773.74 $564.44 $493.18 $88.11 Source: 2007/8 AAP Medicaid Reimbursement Survey. Copyright 2008 American Academy of Pediatrics. * See abbreviations and (foot)notes, by state, at front and end of report.

21

State* Dental Services D0120 D1203 D1120 D2150 D2330 D1351 D2930 D3220 D7140

Alabama NP NP NP NP NP NP NP NP NP Alaska $31.00 $18.00 $48.00 $95.50 $85.00 $30.50 $156.50 $97.00 $80.00 Arizona NL NL NL NL NL NL NL NL NL Arkansas $26.60 $19.95 $36.10 $79.80 $76.00 $28.50 $139.65 $85.50 $71.25 California $15.00 $18.00 $30.00 $48.00 $55.00 $22.00 $75.00 $71.00 $40.00 Colorado $17.55 $13.42 $26.85 $56.79 $57.82 $18.59 $98.09 $61.95 $51.00 Connecticut $18.80 $15.75 $22.56 $39.14 $35.46 $18.46 $88.41 $47.27 $34.44 Delaware * * * * * * * * * Dist. Columbia $35.00 $290.00 $47.00 $115.00 $106.00 $38.00 $102.40 $134.00 $110.00 Florida $15.00 $11.00 $14.00 $41.00 $34.00 $13.00 $68.00 $50.00 $27.00 Georgia $22.77 $17.59 $32.08 $77.62 $71.41 $27.94 $143.86 $90.04 $64.17 Hawaii $29.12 $4.16 $26.00 $40.40 $34.36 $24.32 $74.36 $67.60 $46.80 Idaho $17.76 $13.58 $29.24 $57.45 $52.22 $20.89 $88.78 $52.22 $44.91 Illinois NP NP NP NP NP NP NP NP NP Indiana $20.25 $22.25 $34.50 $64.50-$72.75 $71.00 $27.75 $139.75 $94.25 $72.25 Iowa $16.47 $14.41 $24.70 $58.66 $52.48 $20.58 $102.91 $59.69 $51.46 Kansas $21.00 $17.00 $30.00 $64.00 $66.00 $24.92 $120.00 $60.00 $42.50 Kentucky $33.00 $15.00 $48.10 $65.00 $57.20 $19.50 $119.60 $344.50 $49.40 Louisiana $23.00 $14.00 $19.00 $69.00-$73.00 $81.00 $24.00 $135.00 $50.00 $58.00 Maine $13.00 $12.00 $30.00 $48.00 $68.00 $16.00 $120.00 $50.00 $67.00 Maryland $15.00 $14.00 $24.00 $88.00 $84.00 $9.00 $154.00 $60.00 $40.00 Massachusetts $26.00 $24.00 $62.00 $90.00 $86.00 $36.00 $181.00 $104.00 $88.00 Michigan $14.89** $13.23 $19.53 $48.41 $46.94 $15.12 $84.00 $66.15 $44.47 Minnesota $18.70 $14.00 $18.34 $41.65 $36.70 $17.30 $76.51 $40.80 $44.70 Mississippi NC $12.00 $24.00 $60.00 $55.80 $23.40 $104.40 $71.40 $52.80 Missouri $24.00 $10.00 $18.50 $36.00 $36.00 $19.00 $66.00 $41.50 $33.50 Montana NP NP $28.30 $62.26 $56.60 $22.64 $113.20 $84.90 $62.26 Nebraska $16.00 $7.50 $20.25 $62.00 $59.00 $20.00 $123.00 $70.00 $52.00 Nevada $33.24 $18.39 $57.28 $86.04 $56.38 $23.58 $92.25 $61.50 $45.10 New Hampshire $28.00 $18.00 $38.00 $104.00 $82.00 $30.00 $200.00 $87.00 $82.00 New Jersey $14.00 $9.00 $13.00 $35.50 $33.00 $9.00 $70.00 $26.00 $30.00 New Mexico $22.97 $18.37 $32.15 $74.66 $71.20 $24.32 $120.11 $81.55 $67.76 New York $29.00 $14.00 $43.00 $84.00 $58.00 $43.00 $116.00 $87.00 $45.00 North Carolina $27.01 $15.44 $24.50 $79.41 $62.78 $29.93 $144.25 $78.11 $57.50 North Dakota $23.17 $20.33 $29.73 $72.14 $73.28 $23.78 $111.56 $75.20 $61.18 Ohio $16.74 $14.70 $33.45 $52.92 $50.19 $21.56 $99.88 $62.47 $51.40 Oklahoma $23.50 $16.70 $33.57 $73.85 $67.14 $26.86 $134.28 $100.71 $73.85 Oregon $23.23 $12.73 $28.06 $45.74 $38.56 $18.96 $71.79 $48.33 $75.19 Pennsylvania $20.00 $17.00 $22.00 $50.00 $45.00 $25.00 $90.00 $50.00 $45.00 Rhode Island $10.00 $18.00 $22.00 $37.00 $35.00 $18.00 $88.00 $59.00 $39.00 South Carolina $22.00 $17.00 $31.00 $75.00 $69.00 $27.00 $139.00 $87.00 $62.00 South Dakota $22.94 $18.00 $31.09 $75.00 $68.54 $24.97 $129.07 $68.00 $66.61 Texas $29.44 $15.00 $37.50 * $79.34 $28.82 $156.06 $87.96 $67.04 Utah $14.15 $7.52 $22.81 $41.98 $31.94 $17.34 $65.45 $21.90 $41.98 Vermont $18.00 $15.00 $29.00 $67.00 $65.00 $28.00 $116.00 $75.00 $75.00 Virginia $20.15 $20.79 $33.52 $75.53 $74.28 $32.28 $136.93 $83.19 $69.00 Washington $22.46 $13.66 $23.69 $63.88* $61.21** $22.66 $91.81*** $45.33**** $59.43 West Virginia $20.00 $15.00 $30.00 $72.00 $58.00 $24.00 $122.13 $42.00 $44.00 Wisconsin $15.76 $12.76 $21.60 $44.55 $40.91 $16.99 $87.30 $47.58 $41.81 Wyoming $32.00 $20.00 $35.00 $82.00 $82.00 $28.00 $136.00 $86.00 $70.00 Source: 2007/8 AAP Medicaid Reimbursement Survey. Copyright 2008 American Academy of Pediatrics. * See abbreviations and (foot)notes, by state, at front and end of report.

xiv

6. Footnotes, by State

State Footnote(s)

Alabama None

Alaska None

Arizona None

Arkansas * Includes payment for vaccine and administration

California None

Colorado None

Connecticut None

Delaware * 85% of billed charges Dist of Columbia None

Florida

* Covered for family planning only. ** Pediatric Surgery fee paid at $173.19. *** Enhanced rate of $136.9 for HPV for ages 19-20 only. ^ State pays $10.00 for administration of each state-provided vaccine if service is submitted under vaccine-specific code.

Georgia

*Regular rates shown in this report. However, state indicated enhanced pediatric rates for the following codes paid at 300%-600% of regular rates: 93303, 993307, 93320, 93501, 93510, 94010 and 71010. Inquiry was submitted to state to clarify requirements for enhanced payment rate payment.

Hawaii None

Idaho None

Illinois

*Rates shown are enhanced pediatric rates paid to approximately 5,000 currently participating pediatric or family practice physicians. Requirements to qualify for the enhanced rates are described in the physician handbook in Section A-240, Maternal and Child Health Program. (URL: http://www.hfs.illinois.gov/assets/ 101006_physician.pdf ). ** Qualified Medicare Beneficiary coverage only.

Indiana *Medicaid (1) reimburses $8.00 for administration of VFC vaccines, and (2) pays 100% AWP if vaccines not provided by VFC.

Iowa None

Kansas None

Kentucky None

Louisiana

* denote enhanced pediatric payments for ages 0-15. ** State indicated that codes 90465-90468 and 90473-90474 are currently being processed to become payable in the near future.

Maine None

Maryland *Administration fee paid at $13.50 per vaccine.

Massachusetts *Rates shown include an additional $10 paid as enhanced pediatric payment for E&M services. ** Professional Component only.

Michigan * Fee based upon admit to hospital or discharge. ** State also pays $14.89 for D0145 - Oral Evaluation younger than 3.

Minnesota None

xv

Mississippi None

Missouri None

Montana None

Nebraska None

Nevada None New Hampshire None

New Jersey * 90645/6 not covered; 90647 - $29.02; 90648 - $27.0. ** Specialists receive additional 40%+ payment than shown.

New Mexico None

New York *NY's FFS Medicaid pays providers $2 for administration of VFC vaccines, or invoice cost of vaccines if they are not supplied by VFC.

North Carolina None

North Dakota None

Ohio None

Oklahoma None

Oregon None

Pennsylvania * Provider must be enrolled as Laboratory, Provider Type 28.

Rhode Island *Vaccines are provided at no cost by the Rhode Island Department of Health, but FFS Medicaid does not reimburse for vaccine administration.

South Carolina None

South Dakota None

Tennessee None

Texas *D2150: Primary - $82.90; Permanent - $87.46

Utah

* Covered only for visits to psychologists, certified social workers, agency, alcohol and drug center and mental health center. Rate shown is payment for psychologists. Payment to others are 5% to 17% higher.

Vermont * Request sent to state for clarification of payment method.

Virginia *Vaccines available through VFC. Flat fee of $11.00 for vaccine administration. ** evaluated on a case-by-case basis, may be non-covered in some cases.

Washington * Additional $6.09 for 5 or younger **Additional $2.40 for 5 or younger ***Additional $63.74 for 5 or younger **** Additional $50.08 for 5 or younger

West Virginia *Professional Component only. ** Facility rate.

Wisconsin * Included in Preventive Visit payment. ** Included in lab fee.

Wyoming None