Two questions drive most searches for the Mississippi Medicaid fee schedule. What does Medicaid pay for a service? And what do you owe? They have different answers, and blurring them together is where the confusion starts.
The Mississippi Division of Medicaid (DOM) publishes official fee schedules for medical and surgical services, dental, therapy, behavioral health, durable medical equipment, laboratory services, transportation, long-term care and more. Every schedule has its own effective date.
Last reviewed: September 30, 2026
What Is the Mississippi Medicaid Fee Schedule?
It’s the official reference for reimbursement amounts on covered Medicaid services. DOM doesn’t publish one master rate table. You get comprehensive schedules and service-specific ones instead.
Find a billing code and you can see the Medicaid payment tied to that service. Your personal bill won’t be there. A fee-schedule amount is not automatically what you owe your doctor, dentist, hospital or any other provider.
Why Does the Fee Schedule Matter?
Payment depends on details, and one wrong detail makes the number you found irrelevant.
A Medicaid payment is shaped by:
- The service provided
- CPT, HCPCS or CDT code
- Provider type
- Date of service
- Effective date of the applicable schedule
- Modifiers and units
- Coverage rules
- Prior authorization requirements
- Fee-for-service or managed-care arrangement
- Medical necessity and claim-processing rules
DOM also points providers to current CPT, HCPCS, CDT and ICD-10 coding references.
Mississippi Medicaid Fee Schedule 2026: Current Schedule Updates
No single 2026 update date exists. DOM’s fee-schedule page lists a different date for nearly every service category.
| Service category | Current schedule/update shown by DOM |
|---|---|
| Medical & Surgical Services | July 2026 |
| Ambulatory Surgical Centers | July 2026 |
| Therapy Services | July 2026 |
| Dental Services | July 2026 |
| Behavioral Health Services | July 2026 |
| Autism Spectrum Disorder Services | July 2026 |
| PPEC | July 2026 |
| Private Duty Nursing | September 2026 |
| Anesthesia Base Units | April 2026 |
| Ambulance | January 2025 |
| Nursing Facilities | Quarterly 2026 rate periods |
| Hospice | FY 2026 |
Schedules get revised and replaced, so check the official DOM page before relying on any specific rate. If you’re weighing Mississippi against its neighbors, this Medicaid fee schedule by state comparison lays the differences out side by side.
Does Mississippi Medicaid Have a 2026 Fee Schedule?
Yes, several. Which one applies depends on your service or provider category and its effective date. DOM currently lists a July 2026 comprehensive fee schedule, along with separate schedules for areas like behavioral health and PPEC.
Does the Mississippi Medicaid Fee Schedule Tell You What You Pay?
Usually not. The rate describes reimbursement. What you actually owe comes from Medicaid coverage, program rules and how the claim is processed.
CMS treats three figures separately: the Medicaid allowed amount, the Medicaid payment and the beneficiary’s cost-sharing liability. Money moves through them in this order:
Provider charge → Medicaid allowed amount → Medicaid payment → beneficiary responsibility
Each step can land on a different number.
What About Medicaid Copays in Mississippi?
The rules changed here, and plenty of websites never caught up.
DOM announced that all Medicaid copayments for pharmacy and health-care services were eliminated effective May 1, 2023. Both fee-for-service and MississippiCAN claims were covered. A page telling you Mississippi Medicaid charges a $3 copay is out of date.
No copays doesn’t mean no cost questions. Eligibility, coverage restrictions, third-party liability and other program rules still touch every claim. Eligibility itself comes down to income, and this breakdown of Medicaid income limits and eligibility thresholds shows where the lines sit.
How to Check a Mississippi Medicaid Rate
Work through these in order:
- Identify the service. Pin down exactly what was provided: an office visit, lab test, dental procedure, therapy session or medical supply.
- Find the billing code. Depending on the service, that’s a CPT, HCPCS or CDT code.
- Choose the correct DOM schedule. The comprehensive medical schedule doesn’t cover everything.
- Check the effective date. Match the schedule to the date the service happened.
- Check modifiers and units. Some rates shift based on billing details beyond the procedure code.
- Check coverage rules. A code on a schedule doesn’t mean every beneficiary qualifies for that service.
- Check prior authorization. Certain procedures need approval first.
- Determine the payment arrangement. Fee-for-service Medicaid or MississippiCAN?
Eight steps beat copying a number off an old third-party site every time.
Mississippi Medicaid Fee Schedule by Service
DOM keeps separate rate resources for different parts of the program. Here are the main ones:
- Medical and surgical services
- Dental services
- Behavioral health
- Autism Spectrum Disorder services
- Therapy
- Durable medical equipment and medical supplies
- Laboratory services
- Ambulance transportation
- Private-duty nursing
- Nursing facilities
- Hospice
- HCBS waiver services
- Hospital-related services
- Ambulatory surgical centers
- PPEC services
The current list, with links to each schedule, lives on the official DOM fee-schedule page.
Mississippi Medicaid Dental Fee Schedule
Dental runs on its own schedule. Don’t assume a medical CPT rate applies, because dental work uses CDT codes while medical services typically use CPT or HCPCS.
Wondering whether Medicaid covers a cleaning, filling or extraction? Two checks settle it:
- Whether the service is covered for your eligibility category
- The applicable dental fee or reimbursement information
A listed amount guarantees nothing. Coverage for your situation is a separate question.
CPT, HCPCS, CDT and ICD-10: What’s the Difference?
Once you know the code type, a fee-schedule search gets much easier.
| Code/system | General purpose |
|---|---|
| CPT | Medical procedures and professional services |
| HCPCS | Healthcare services, supplies and products, including items beyond CPT |
| CDT | Dental procedures |
| ICD-10-CM | Diagnoses and medical conditions |
Fee schedules focus on the procedure being billed. ICD-10-CM describes the diagnosis, so it’s not a reimbursement code. Modifiers and units also change how a claim processes.
Mississippi Medicaid Fee-for-Service vs MississippiCAN
Depending on eligibility and program rules, you’ll land in either fee-for-service (FFS) or managed care through MississippiCAN. Three coordinated care organizations run MississippiCAN: Magnolia Health, Molina Healthcare of Mississippi and Mississippi TrueCare.
DOM’s current MississippiCAN resources confirm all three.
| FFS Medicaid | MississippiCAN |
|---|---|
| State-administered fee-for-service payment structure | Managed-care arrangement |
| DOM fee schedules are important payment references | Plan/network and contract rules can also matter |
| Claims are processed under applicable FFS rules | Claims may be administered through the member’s CCO |
| Coverage rules still apply | Network and plan requirements also matter |
So a fee-schedule amount can’t tell you exactly how a managed-care claim will be handled.
Does a Fee Schedule Guarantee Medicaid Payment?
No. A listed fee is not a promise of payment.
Claims get paid or denied based on:
- Member eligibility on the date of service
- Covered-service rules
- Provider enrollment
- Correct coding
- Medical necessity
- Prior authorization
- Modifiers and units
- NCCI edits
- Claim-processing requirements
- Managed-care rules
DOM maintains separate resources for prior authorization and other provider billing requirements.
Fee Schedule vs Provider Charge
Providers set a standard charge. Medicaid applies its own reimbursement methodology. The two rarely match, and the terms aren’t interchangeable.
| Term | What it generally means |
|---|---|
| Provider charge | Amount a provider bills or lists for a service |
| Fee-schedule rate | Published reimbursement information for an applicable service |
| Allowed amount | Amount recognized under the applicable Medicaid payment rules |
| Medicaid payment | Amount paid by Medicaid or the applicable managed-care organization |
| Beneficiary responsibility | Amount the member is legally responsible for under applicable rules |
CMS draws the same lines between allowed amounts, Medicaid payments and beneficiary cost-sharing.
Prior Authorization and Other Requirements
People trip over this constantly: they see a service on the fee schedule and assume they can simply get it. Some services need prior authorization first. DOM offers a procedure-code PA requirement resource that shows whether authorization rules apply.
Medical necessity, provider qualifications, coverage limits, NCCI edits, correct billing codes, required documentation and date-of-service policies all count too.
For anything important or expensive, verify coverage and authorization before you receive the service. Afterward is too late.
Program rules keep moving. If eligibility changes are on your radar, read up on the new Medicaid work requirements by state.
Mississippi Medicaid Providers Near Me
A fee schedule won’t tell you who to see. Searching “Medicaid doctor near me” or “Mississippi Medicaid provider near me” takes different information:
- Provider location
- Specialty
- Whether the provider accepts Mississippi Medicaid
- Whether the provider participates in your MississippiCAN plan
- Whether the provider is accepting new patients
That holds in Jackson, Gulfport, Hattiesburg, Biloxi, Southaven, Tupelo, Meridian or anywhere else in the state. The fee schedule itself is statewide. Rates don’t shift when you cross a city line.
Common Mistakes When Checking Mississippi Medicaid Rates
Seven errors show up again and again.
Using an old rate. A 2024 claims average is not a 2026 fee-schedule rate.
Using the wrong schedule. Dental, behavioral health, therapy, DME and other services each have their own.
Ignoring the effective date. The right rate follows the date of service.
Treating the rate as your bill. Reimbursement information isn’t patient responsibility.
Assuming a code means coverage. Eligibility and coverage rules still apply.
Ignoring MississippiCAN. Managed care adds plan and network considerations.
Relying on a random rate database. Third-party sources help with research, but DOM should be your primary source for the current Mississippi schedule.
Official Mississippi Medicaid Resources
Start with the Mississippi Division of Medicaid. Its official fee-schedule page carries the current schedules and rate resources.
For managed care, DOM’s MississippiCAN resources identify the current CCO structure. Member plan information lists Magnolia Health, Molina Healthcare of Mississippi and Mississippi TrueCare as the three current MississippiCAN health plans.
Entity Glossary
Mississippi Division of Medicaid (DOM): Mississippi’s state Medicaid agency.
Mississippi Medicaid: The state’s Medicaid program administered by DOM.
MississippiCAN: Mississippi’s managed-care Medicaid program.
CPT: Medical procedure coding system.
HCPCS: Healthcare procedure and supply coding system.
CDT: Dental procedure coding system.
ICD-10-CM: Diagnosis classification system.
MESA: Mississippi Medicaid’s electronic administrative/provider portal environment.
NCCI: National Correct Coding Initiative edits used to identify certain coding combinations that should not be reported together.
Prior authorization: Approval required by the Medicaid program or applicable plan before certain services are provided.
FAQs
What is the Mississippi Medicaid fee schedule?
A collection of official reimbursement schedules published by the Division of Medicaid. Each service and provider category can carry its own schedule and effective date.
What is the Mississippi Medicaid fee schedule for 2026?
There’s no single universal table. Mississippi has multiple 2026 schedules, and DOM currently lists July 2026 for many major services while other categories carry different effective dates.
How do I check a Mississippi Medicaid rate?
Identify the service and its CPT, HCPCS or CDT code. Pick the applicable DOM fee schedule, confirm its effective plan, then verify coverage, authorization and payment policies.
Does the fee schedule tell me what I will pay?
No. The amount reflects reimbursement only.
Does Mississippi Medicaid have copays?
Not anymore. DOM eliminated Medicaid copayments for pharmacy and health-care services effective May 1, 2023, for both FFS and MississippiCAN claims.
Does Mississippi Medicaid cover dental services?
Some dental services are covered, depends on your eligibility and Medicaid policies. Check the Mississippi Medicaid dental resources for the specific service you required.
Does MississippiCAN use the Mississippi Medicaid fee schedule?
MississippiCAN runs through contracted coordinated care organizations, so plan, network and contract rules apply alongside general Medicaid payment information. DOM currently identifies Magnolia, Molina and Mississippi TrueCare as the three CCOs.
Does a Medicaid fee schedule guarantee payment?
No. Eligibility, coverage, coding, authorization, medical necessity, provider requirements and claim rules all decide whether a claim gets paid.
Why do Mississippi Medicaid schedules have different dates?
Categories are updated independently. DOM’s listings show multiple effective and update dates throughout 2026.
Can I use a 2024 Medicaid payment average as a 2026 rate?
No. A historical claims average and a published fee-schedule rate are different things. Verify the current rate on the applicable DOM schedule.
Where can I find the official Mississippi Medicaid fee schedule?
On the Mississippi Division of Medicaid’s official Fee Schedules and Rates page.
Official Resources
- Check Current Mississippi Medicaid Rates — Mississippi Division of Medicaid
- Verify Your Coverage and Eligibility — Mississippi Division of Medicaid
- Find Your MississippiCAN Health Plan — Mississippi Division of Medicaid
- Apply for Mississippi Medicaid Online — Access.ms.gov
Conclusion
The Mississippi Medicaid fee schedule 2026 is a reimbursement reference. It was never a price tag for you personally.
Before you act on any number, verify the schedule date, the billing code, and whether prior authorization stands between you and the service. Then call DOM or your MississippiCAN plan and ask. Five minutes on the phone beats a surprise denial.
Disclaimer: This guide is for general educational only and is not official Mississippi Medicaid advice. Fee plans, coverage policies and payment rules can change. Always confirm the latest rate, coverage and authorization requirements with Mississippi DOM or your MississippiCAN health plan.