The Iowa Medicaid Provider Fee Schedules are listed below. Also available are several resources and a document that explains the factor codes and pricing modifiers found on the fee schedules.
- Open Fee Schedules (Updated November 2024)
- Archived fee schedules can be found at Iowa Publications Online
- Iowa Medicaid Procedure Code Modifiers
- Crisis Response Services and Subacute Mental Health Service Fee Schedule
- Low Utilization Payment Adjustment (LUPA) Rate Sheet (Effective July 1, 2024)
- Medical Transportation Providers Fee Schedule
- Pharmacy Dispensing Fee (Updated September 2024)
- Ambulatory Payment Classification (APC) Documents
- Iowa and Out-of-State Hospice Wage Indexes and Rates
- Integrated Health Home Per-Member-Per-Month (PMPM) Fee Schedule for Fee-for-Service (FFS) Members
- HCBS Billing Code Chart
- HCBS Waiver Consumer Choices Options (CCO) Fee Schedule
- HCBS ID Waiver Tiered Fee Schedule
- HCBS ID Waiver Tiered Rates Frequently Asked Questions (FAQ) (November 1, 2017)
- HCBS Waiver and Habilitation Prevocational and Supported Employment Fee Schedule
- HCBS Waiver Transportation Upper Rate Limits
- HCBS Habilitation and Waiver Upper Rate Limits (July 1, 2024)
- HCBS Habilitation Home-Based Habilitation Fee Schedule
Some people have reported trouble opening the "Open Fee Schedule" file. If you encounter this problem, please follow the instructions below to reset your personal settings on the Windows OS.
- Close all IE and Chrome windows
- Go to the Windows "Start" button on the lower left corner of the Windows desktop
- Choose "Control Panel"
- Choose "Internet Options"
- Choose the "Advanced" tab on the far right of the tabs selection
- Click on the "Reset" button at the bottom of the "Advanced" tab
- Check the box "Delete Personal Settings"
- Click "Reset"
- This should fix the problem. Go back to the "Open Fee Schedules"
There is no need to restart your computer.
End User Agreement for Providers
LICENSE FOR USE OF "PHYSICIANS' CURRENT PROCEDURAL TERMINOLOGY", (CPT)
FOURTH EDITION
End User/Point and Click Agreement:
CPT codes, descriptions and other data only are copyright 2008 American Medical Association (AMA). All Rights Reserved (or such other date of publication of CPT). CPT is a trademark of the AMA.
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Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized here in must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. Applications are available at the AMA Web site.
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AMA Disclaimer of Warranties and Liabilities
CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. The AMA warrants that due to the nature of CPT, it does not manipulate or process dates, therefore there is no Year 2000 issue with CPT. The AMA disclaims responsibility for any errors in CPT that may arise as a result of CPT being used in conjunction with any software and/or hardware system that is not Year 2000 compliant. No fee schedules, basic unit, relative values or related listings are included in CPT. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this file/product is with Noridian Administrative Services or the CMS and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product.
CMS Disclaimer
The scope of this license is determined by the AMA, the copyright holder. Any questions pertaining to the license or use of the CPT must be addressed to the AMA. End Users do not act for or on behalf of the CMS. The CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. The CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.
This license will terminate upon notice to you if you violate the terms of this license. The AMA is a third party beneficiary to this license.
POINT AND CLICK LICENSE FOR USE OF "CURRENT DENTAL TERMINOLOGY", ("CDT")
End User License Agreement
These materials contain Current Dental Terminology, (CDT), copyright © 2002, 2004 American Dental Association (ADA). All rights reserved. CDT is a trademark of the ADA.
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1. Subject to the terms and conditions contained in this Agreement, you, your employees, and agents are authorized to use CDT only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Use of CDT is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials.
2. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. License to use CDT for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. Applications are available at the American Dental Association web site, http://www.ADA.org/.
3. Applicable Federal Acquisition Regulation Clauses (FARS)\Department of Defense Federal Acquisition Regulation Supplement (DFARS) Restrictions Apply to Government use. Please click here to see all U.S. Government Rights Provisions.
4. ADA DISCLAIMER OF WARRANTIES AND LIABILITIES. CDT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. No fee schedules, basic unit, relative values or related listings are included in CDT. The ADA does not directly or indirectly practice medicine or dispense dental services. The sole responsibility for the software, including any CDT and other content contained therein, is with (insert name of applicable entity) or the CMS; and no endorsement by the ADA is intended or implied. The ADA expressly disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon notice to you if you violate the terms of this Agreement. The ADA is a third-party beneficiary to this Agreement.
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