Fee Schedules

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 2020

    APC Fee Schedule 2019   

    APC Status Codes

    Frequently Asked Questions

    Laboratory Procedure Codes

    Radiology Procedure Codes

    All Patient Refined Diagnosis Related Groups (APR-DRGs)

    RI DRG Calculator July 1, 2020

    RI DRG Calculator (older versions)

    Frequently Asked Questions 

    J Codes Requiring NDC

    J Code Conversion Table

     

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