Mississippi Medicaid Reimbursement Rates 2027: Fee Schedule

Mississippi Medicaid doesn’t pay one statewide amount. The Mississippi Division of Medicaid (DOM) sets payment by service, procedure code, provider type, date of service and payment system, and each of those can change the number on your claim. If you want to see how the state compares with others, our breakdown of Medicaid reimbursement rates by state puts Mississippi in context.

DOM’s official fee-schedule hub splits information into physician and medical services, dental, hospital, HCBS, behavioral health, DME, laboratory and radiology, transportation, nursing facilities, hospice, clinics and other provider categories.

So skip the question “What does Mississippi Medicaid pay?” Ask this instead: what code, service, provider type, effective date and payment method apply to this claim?

That matters more in 2027 than usual. Some rates are final and published. Others are still proposals waiting on approval.

Table of Contents

How to Find a Mississippi Medicaid Reimbursement Rate

Work through these steps in order:

Identify the procedure or service code. It can be CPT, HCPCS, CDT or another applicable code.
Identify the provider or facility type. Physicians, dentists, hospitals, DME suppliers and therapists each use different schedules.
Find the appropriate DOM fee schedule.
Check the effective date. A 2026 rate doesn’t carry through 2027 automatically.
Review modifiers, units and billing requirements.
Determine whether the claim is fee-for-service (FFS) or managed care.
Verify the final claim payment through the applicable provider systems and remittance advice.

DOM offers a downloadable Comprehensive Fee Schedule and an Interactive Fee Schedule through its provider resources.

Keep one thing straight: a fee-schedule amount is not a promise. Not every provider receives that exact figure on every claim.

Mississippi Medicaid Fee Schedule 2027: What You Need to Know

No single “Mississippi Medicaid fee schedule 2027” covers every service. DOM organizes rates by program and provider category, and the current schedules look like this:

Time periods vary too. Nursing-facility schedules run quarterly, while other schedules take effect on July 1 or follow the calendar year.

SFY 2027 vs. Calendar Year 2027

State Fiscal Year 2027 (SFY 2027) generally begins July 1, 2026. Some Mississippi Medicaid rates follow that fiscal calendar. Others are published by calendar year, by quarter or on another effective period.

A search for “2027 Medicaid rates” therefore points to no universal effective date.

Before you bill or build a budget on any rate, confirm the schedule’s effective date and its publication status.

Mississippi Medicaid Physician Reimbursement Rates

Physician rates draw the most searches, and for good reason. Providers want the Mississippi Medicaid CPT rate for a specific service, and they want it fast.

Mississippi’s State Plan ties physician payment to the Medicare Physician Fee Schedule. That link has limits. It doesn’t mean every Mississippi Medicaid service pays 90% of Medicare.

Searches like these all need the same treatment:

Mississippi Medicaid 99213 reimbursement
Mississippi Medicaid 99214 reimbursement
Mississippi Medicaid E/M reimbursement
Mississippi Medicaid primary-care rates
Mississippi Medicaid specialist reimbursement

Check the applicable code, the schedule, the provider circumstances and the effective date. A Medicare comparison is a useful reference point, but Medicare and Medicaid amounts are not interchangeable.

Mississippi Medicaid Hospital Reimbursement Rates

Hospitals are paid under methodologies that have little in common with an ordinary physician fee schedule.

Inpatient hospital reimbursement

Inpatient claims run on an APR-DRG methodology. For hospital discharges effective July 1, 2026, DOM lists these updated parameters:

Solventum APR-DRG Grouper Version 43
Re-centered Hospital-Specific Relative Value (HSRV) weights
Base payment of $5,608
Neonate policy adjustor of 1.44
DRG cost-outlier threshold of $88,000

Those figures belong to the specified APR-DRG methodology. They are not a flat payment for every admission.

The related APR-DRG State Plan Amendment went to CMS, so the status of any methodology change deserves a look when you evaluate reimbursement information.

Outpatient hospital reimbursement

Outpatient services use OPPS, not APR-DRG. Mississippi’s State Plan sets the OPPS fee schedule as of July 1 each year, with procedure-specific status indicators and payment rules attached. Always treat “hospital reimbursement” as two separate questions: inpatient and outpatient.

Mississippi Medicaid HCBS Rates 2027

Home and Community-Based Services are the other big 2027 story.

DOM finished rate-study work covering 1915(c) waiver and 1915(i) services. The SFY 2027 materials list proposed rates, and DOM states plainly that these are strictly proposals. Implementation depends on legislative action, funding and CMS approval.

A proposed HCBS rate is not the final Mississippi Medicaid rate for 2027. Don’t describe it that way.

The programs and services in scope include:

Elderly & Disabled Waiver
Assisted Living Waiver
ID/DD services
Independent Living services
TBI/SCI services
Personal care
Other 1915(c) and 1915(i) services

If you’re budgeting or forecasting revenue, this status question is the one to get right.

Dental, Pharmacy and Other Medicaid Rates

Dental reimbursement

Dental has its own fee schedule, separate from physician services. Search CDT codes such as D1110, D2391 or D7140 in the dental schedule. The amount for any dental service follows the code, the billing circumstances and the effective schedule.

Pharmacy reimbursement

Pharmacy runs on drug pricing, preferred-drug policies, prior authorization and its own set of requirements.

One 2027 change is already on the calendar. Beginning January 1, 2027, Mississippi Medicaid providers must submit pharmacy prior-authorization requests electronically through the MESA Provider Portal. DOM and Gainwell have told providers to set up portal access before the requirement starts.

DME, therapy, behavioral health and transportation

Mississippi Medicaid keeps separate reimbursement information for:

Durable medical equipment
Therapy
Behavioral health
Laboratory and radiology
Transportation
Home health
Hospice
Rural Health Clinics
Federally Qualified Health Centers
ESRD
Nursing facilities
PRTF
ICF-IID

Each follows its own methodology. Apply a physician reimbursement percentage to any of them and you’ll get the wrong answer.

Mississippi Medicaid FFS vs. MississippiCAN

Fee-for-service (FFS) Medicaid and MississippiCAN managed care get confused constantly. They’re different systems.

A fee schedule sets the Medicaid payment for an applicable FFS service. A provider in a managed-care network is paid under the arrangement and contract with the Coordinated Care Organization instead. So “What is the Mississippi Medicaid rate?” leads straight to another question: is this claim paid through FFS or MississippiCAN?

MESA is the main provider technology environment for Mississippi Medicaid, covering provider enrollment and other provider resources. MississippiCAN providers also carry network and contracting requirements with their CCO. Coverage rules matter here as well, and our guide to Mississippi Medicaid income limits explains who qualifies for the program in the first place.

Fee Schedule Amount vs. Actual Claim Payment

The published rate and the amount on your remittance advice don’t always match.

Here’s the path a claim takes:

Fee schedule → code and billing rules → claim adjudication → allowed amount → payer methodology → adjustments → final payment

Modifiers, units, prior authorization, provider enrollment, claim edits and third-party liability can all change what happens along the way.

DOM has also issued notices about claim reprocessing after fee information was found to be incorrect. That’s the reason to read your remittance advice instead of trusting an old rate table.

What Providers Should Check Before Billing

Run through this list before you rely on any Mississippi Medicaid rate:

Correct CPT, HCPCS or CDT code
Provider taxonomy/type
Place of service
Modifier requirements
Units and service limits
Prior authorization requirements
Effective date
FFS or MississippiCAN status
Current DOM fee schedule
Applicable State Plan methodology
Claim and remittance information

DOM keeps a separate prior-authorization resource for pharmacy and non-pharmacy services, and the MESA Provider Portal carries provider resources, billing materials and fee-schedule access.

Common Mistakes With Mississippi Medicaid Rates

Providers keep making the same eight errors:

Using an outdated PDF.
Treating one Medicaid rate as applicable to every provider.
Confusing Medicare rates with Medicaid rates.
Treating a proposed 2027 rate as final.
Ignoring the date of service.
Confusing FFS with MississippiCAN.
Overlooking modifiers or authorization requirements.
Assuming the fee-schedule amount guarantees the final claim payment.

In 2027, check status and effective date first. Several reimbursement changes are still moving through policy, legislative and CMS processes.

FAQs About Mississippi Medicaid Reimbursement Rates

1. What are Mississippi Medicaid reimbursement rates for 2027?

There’s no single rate. Rates vary by service, procedure code, provider type, payment methodology and effective date, and the official Mississippi Division of Medicaid fee-schedule hub is where you check them.

2. Does Mississippi Medicaid pay 90% of Medicare?

For certain physician services, yes, under Mississippi’s payment methodology. It is not a universal rule for every Mississippi Medicaid service.

3. How do I find a Mississippi Medicaid CPT reimbursement rate?

Start with the CPT code, provider type and date of service, then look it up in the applicable DOM fee schedule. Review modifiers and authorization requirements next, and confirm whether the claim is FFS or managed care.

4. How much does Mississippi Medicaid pay for CPT 99213 or 99214?

Look up the amount in the current Mississippi Medicaid physician/medical fee schedule for the relevant effective period. The code alone won’t tell you the final claim payment.

5. What is the Mississippi Medicaid hospital reimbursement method?

Inpatient hospital services use APR-DRG. Outpatient hospital services use OPPS. The current inpatient methodology includes updated APR-DRG parameters for discharges beginning July 1, 2026.

6. Are Mississippi Medicaid HCBS rates for 2027 final?

No. DOM’s SFY 2027 HCBS materials list proposed rates, and implementation requires the applicable policy, legislative funding and CMS approval.

7. What is MESA in Mississippi Medicaid?

MESA is Mississippi Medicaid’s provider portal environment. Providers use it for enrollment and administrative functions, and it links to billing and fee-schedule resources through DOM’s provider system.

8. Will Mississippi Medicaid rates be the same for MississippiCAN?

No. FFS fee schedules and managed-care payment arrangements are separate systems. Confirm which payer and arrangement apply before you treat a published FFS rate as your MississippiCAN payment.

9. When do Mississippi Medicaid 2027 rates take effect?

No single date covers them all. Schedules follow July 1, calendar-year, quarterly or other periods, so check the effective date on the specific schedule you’re using.

10. How can providers verify a Mississippi Medicaid claim payment?

Review the applicable fee schedule and billing requirements, then check the adjudicated claim and remittance advice through the provider systems. MESA supplies provider resources and billing information.

11. What changes are coming to Mississippi Medicaid pharmacy prior authorization in 2027?

Starting January 1, 2027, providers must submit pharmacy prior-authorization requests electronically through the MESA Provider Portal.

Conclusion

Most rate mistakes start before anyone opens a fee schedule. Someone pulls a number without knowing the code, the provider type, the date of service or who’s actually paying. Sort those four out and the schedule gives you something you can work with. When the remittance advice lands, that’s the number that counts.

Official Resources

Short disclaimer: This article provides general information and is not an official Medicaid payment determination. Rates, policies and effective dates can change. Providers should verify current requirements and rates with the Mississippi Division of Medicaid before billing or making financial decisions.

Naseer

About Naseer

Naseer has 10+ years of experience creating informative content and researching medicare topics. He focuses on simplifying Medicaid and benefits details to support readers find clear, reliable, and easy-to-understand guidance.