Current fee-for-service (FFS) rates published by Iowa Dept of Health and Human Services — Iowa Medicaid for primary care codes. Medicaid-vs-Medicare rate comparison for CMS-designated E/M codes (benchmark-first launch).
FFS benchmark rates only — managed care organization (MCO) contract rates may differ. Not legal or compliance advice.
| Code | Description | Variant | Rate | Effective | Status |
|---|---|---|---|---|---|
| 99213 | Established-patient office visit, low-to-moderate complexity — one of CMS's 68 comparative-analysis codes. | AF | $32.88 / visit | 2018-01-01 | Auto-extracted |
| TD FCX | $21.52 / visit | 2018-01-01 | Auto-extracted | ||
| SA FCX | $24.21 / visit | 2018-01-01 | Auto-extracted | ||
| U2 FCX | $24.21 / visit | 2018-01-01 | Auto-extracted | ||
| AF FCX | $32.88 / visit | 2018-01-01 | Auto-extracted | ||
| TD | $30.40 / visit | 2016-01-01 | Auto-extracted | ||
| SA | $34.20 / visit | 2016-01-01 | Auto-extracted | ||
| U2 | $34.20 / visit | 2016-01-01 | Auto-extracted | ||
| TD FC9 | $30.40 / visit | 2016-01-01 | Auto-extracted | ||
| SA FC9 | $34.20 / visit | 2016-01-01 | Auto-extracted | ||
| U2 FC9 | $34.20 / visit | 2016-01-01 | Auto-extracted | ||
| AF FC9 | $46.45 / visit | 2016-01-01 | Auto-extracted | ||
| 99214 | Office visit with moderate complexity, established patient. | TD FCX | $24.11 | 2018-01-01 | Auto-extracted |
| SA FCX | $27.13 | 2018-01-01 | Auto-extracted | ||
| U2 FCX | $27.13 | 2018-01-01 | Auto-extracted | ||
| AF FCX | $36.85 | 2018-01-01 | Auto-extracted | ||
| AF | $50.17 | 2016-01-01 | Auto-extracted | ||
| TD | $32.83 | 2016-01-01 | Auto-extracted | ||
| SA | $36.94 | 2016-01-01 | Auto-extracted | ||
| U2 | $36.94 | 2016-01-01 | Auto-extracted | ||
| AF FC9 | $50.17 | 2016-01-01 | Auto-extracted | ||
| TD FC9 | $32.83 | 2016-01-01 | Auto-extracted | ||
| SA FC9 | $36.94 | 2016-01-01 | Auto-extracted | ||
| U2 FC9 | $36.94 | 2016-01-01 | Auto-extracted |
Source: Iowa Dept of Health and Human Services — Iowa Medicaid
No. These are fee-for-service (FFS) benchmark rates published directly by Iowa's Medicaid agency. Managed care organizations (MCOs) negotiate their own contract rates separately, and those aren't published publicly — FFS rates are commonly used as a reference point, not a guarantee of what an MCO will pay.
It varies by state and code — some update annually, others quarterly or on an as-needed basis. MedicaidBench checks official sources continuously and logs the effective date and source document for every rate change.
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