Fee Schedules

Pediatric Physician Rate Increase

RI Medicaid has implemented a rate increase to allow physicians billing for recipients under the age of 21 years to receive rates equivalent to Medicare.  This rate increase will be retro-actively effective for dates of service on or after July 1, 2022.  Providers should update their billing systems to reflect the new rates in order to be reimbursed correctly.
The new rates can be viewed on the bottom of the Physician Directory page.


Below are the links to the Medicaid Fee Schedules.  

Interactive Fee for Service Fee Schedule

Interactive Outpatient Pricing Fee Schedule (NOT APC Pricing)*

* NOTE:  This is NOT the APC Fee Schedule/See Outpatient Hospital Fee Schedules for APC Fee Schedule. 

Please Note:

  • There are circumstances that may impact pricing such as:  manual pricing, provider-specific certification/pricing, or multiple surgical procedure codes.
  • When the rate is listed as $0, then the claim is priced manually and requires supporting documentation.
  • Pricing Action Code (PAC) values are:
    • Blank - Base Medicaid
    • I - Informational
    • M - Manual 
    • P - Percentage
    • S - Special modifier pricing
  • Fee schedule information will be updated to the web on a weekly basis.
  • Fee schedule data will span the last three years.
  • For additional information or questions, please contact the Customer Service Help Desk at 401-784-8100.


Eleanor Slater Hospital Rates 2019-Interim

Proposed I/DD rates- effective 10/1/19 

EOHHS responses to public comments regarding Independent Provider rates

Home Stabilization - Emergency Case Management during COVID-19 Crisis

National Correct Coding MUE Data  

DME Providers

Outpatient Hospitals, Outpatient Psych, and Dialysis

Ambulatory Surgical Centers and Professional Providers 

Outpatient Hospital Fee Schedules 

For the following items, visit the Hospital Provider Directory page

APC Fee Schedule 2023 Updated October 2023

APC Fee Schedule 2022  

APC Fee Schedule 2021

APC Status Codes Updated October 2023

Frequently Asked Questions

Laboratory Procedure Codes April 2024

Radiology Procedure Codes April 2024

All Patient Refined Diagnosis Related Groups (APR-DRGs)

RI DRG Calculator July 1, 2023

RI DRG Calculator (older versions)

Frequently Asked Questions 

Ambulatory Surgical Center (ASC) Reimbursement

Please visit the ASC page under the Provider Directories for more information.

J Codes Requiring NDC

J Code Conversion Table  Updated April 2024


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