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Individual Practitioner

Medicaid pays physicians on a fee-for-service basis for each service provided to the client. The latest Physician Fee Schedule is available to download.

Other practitioners, such as optometrists, podiatrists, chiropractors and therapists, receive reimbursements at their actual charge, up to a statewide maximum established by the department for each medical procedure.

All Certified Nurse Practitioners (CNP) and Clinical Nurse Specialists (CNS), may enroll with the department. With the exception of psychiatric services (CPT code range 90801 through 90899), which must be rendered by a physician, all services rendered by an APN are reimbursed at 100 percent of the physician’s rate. In addition, APNs may enroll as a primary care provider under the Maternal and Child Health (MCH) program.