As of August 2026, Alabama Medicaid has not yet published a full Fiscal Year 2027 fee schedule. FY 2027 runs from October 1, 2026, through September 30, 2027.
Some 2027 payment details are already set, but most procedure code rates are still pending.
This guide explains what is confirmed, what is not, and where to check for updates.
Quick Summary:
- Alabama Medicaid’s fiscal year runs October 1 to September 30 each year
- FY 2027 fee schedules were due to the agency no later than October 1, 2026
- No published FY 2027 procedure code rate tables exist yet as of this update
- The current confirmed baseline is the FY 2026 fee schedule, effective October 1, 2025
- One confirmed FY 2027 item: a nursing home therapy add-on rate takes effect January 1, 2027
- Use the Medicaid Eligibility Calculator in 2026 to check if you or a family member may qualify for coverage
What Is the Alabama Medicaid Fee Schedule?
The Alabama Medicaid fee schedule is a list of payment rates. It tells providers how much Medicaid pays for each service. Alabama Medicaid Agency updates it once a year, usually on October 1.
Alabama Medicaid uses fee-for-service (FFS) rates for most providers. This includes doctors, therapists, labs, and pharmacies. Rates are tied to CPT, CDT, and HCPCS procedure codes.
Who Uses the Fee Schedule
Medicaid-enrolled providers use this schedule to bill claims correctly. It applies to physicians, therapists, dentists, labs, pharmacies, and durable medical equipment (DME) suppliers. Hospitals and nursing facilities follow related but separate payment rules.
How Often Rates Change
Alabama Medicaid typically updates fee schedules once a year on October 1. Smaller quarterly updates can happen on January 1, April 1, or July 1. These smaller updates usually add new codes or adjust a few rates.
Is There a Confirmed FY 2027 Fee Schedule?
No. As of this update, Alabama Medicaid has not posted a finalized FY 2027 fee schedule. The agency’s own alerts only describe planning steps and deadlines tied to 2027, not final rate tables.
What “FY 2027” Means for Timing
Alabama Medicaid’s Fiscal Year 2027 begins October 1, 2026. It ends September 30, 2027. Providers should watch for new rate postings around that October start date.
What Official Alerts Actually Say
Agency alerts note that FY 2027 fee schedule and rate files were due internally no later than October 1, 2026. This is a submission deadline for the agency’s own process. It is not the same as a public rate release.
Why This Matters for Billing
Providers should keep billing under the current FY 2026 fee schedule until FY 2027 rates post. Using outdated or guessed rates can cause claim errors. Always confirm the effective date on any rate table before relying on it.
Confirmed FY 2027 Payment Details So Far
A few specific 2027 payment items are locked in, even though the full fee schedule is not out yet. These come from Alabama Medicaid Agency alerts on nursing facility payments.
Nursing Facility Therapy Add-On
Alabama Medicaid will set a new therapy add-on rate for skilled nursing facilities effective January 1, 2027. This rate is based on real therapy cost data from each facility’s June 30, 2026 cost report. The agency will reconcile prior add-on payments in April 2027.
Federal Matching Rate (FMAP)
Alabama’s Federal Medical Assistance Percentage for FY 2027 is reported at 72.55%, according to KFF’s compiled federal data. This is the share of Medicaid costs the federal government covers in Alabama. It affects overall program funding, not individual procedure code rates.
Current FY 2026 Fee Schedule (Confirmed Baseline)
Since FY 2027 rates are not published, FY 2026 remains the active fee schedule. These rates took effect October 1, 2025, and run through September 30, 2026.
Sample FY 2026 Rates
- Established patient office visit (CPT 99213): $78.19 for ACHN-enrolled providers
- Well-child screening visits (CPT 99381–99395): $80.00 per visit, effective since July 1, 2025
- Pharmacy dispensing fee: $10.64 per prescription under state law
- ABA therapy code 97153: $10.00 per 15 minutes
- ABA therapy code 97155: $15.00 per 15 minutes
Recent 2026 Updates
Alabama Medicaid moved Applied Behavior Analysis (ABA) codes into a standalone ABA fee schedule in February 2026. Core ABA rates stayed the same as the prior physician fee schedule. Two new Category III codes were added with their own rates.
Alabama Medicaid also updated laboratory fee schedule rates effective October 1, 2025. Durable medical equipment (DME) rates saw quarterly updates through 2026.
What Cannot Be Confirmed for FY 2027 Yet
Some details are simply not available yet. Being clear about this helps providers avoid relying on guesses.
Rates Not Yet Published
No specific FY 2027 procedure code rates exist for physicians, therapists, DME suppliers, or lab services. No FY 2027 inflation factor for general fee updates has been announced. No changes to copayments or prior authorization rules beyond FY 2026 have been confirmed.
Where FY 2027 Rates Will Appear
When Alabama Medicaid Agency releases FY 2027 rates, they will post to the agency’s gated Fee Schedules and Provider Manuals page. Providers can also watch the agency’s Providers section and its official Alerts page for announcements.
How Fee Schedules Connect to Coverage and Eligibility
Fee schedules set what providers get paid. They do not change who qualifies for Medicaid coverage. Eligibility depends on income, household size, and category, such as pregnancy, disability, or age.
If you are unsure whether you qualify for Alabama Medicaid, start with the Medicaid Income Limits by State in 2026 guide. It breaks down current income limits by household size. You can also review Medicaid Eligibility in 2026 to see which coverage categories may apply to your situation.
FAQ
Q: Is there an Alabama Medicaid fee schedule for 2027 yet?
A: No. As of this update, no full FY 2027 fee schedule has been published. The current confirmed rates are still from FY 2026, effective October 1, 2025. Check the agency’s fee schedule page for updates near October 2026.
Q: When does Alabama Medicaid’s fiscal year 2027 start?
A: Alabama Medicaid’s Fiscal Year 2027 starts October 1, 2026. It runs through September 30, 2027. New fee schedules typically post around this date each year.
Q: What is the nursing home therapy add-on for January 2027?
A: Alabama Medicaid will set a new therapy add-on rate for skilled nursing facilities starting January 1, 2027. It uses real cost data from each facility’s June 30, 2026 report. The agency will reconcile payments in April 2027.
Q: What is Alabama’s Medicaid federal match rate for FY 2027?
A: Alabama’s Federal Medical Assistance Percentage (FMAP) for FY 2027 is reported at 72.55%, per KFF’s federal data compilation. This affects state and federal cost-sharing, not individual service rates.
Q: Where can providers find the current fee schedule?
A: The current schedule is on Alabama Medicaid Agency’s gated Fee Schedules and Provider Manuals page. You must accept CPT and CDT licensing terms to view it. The agency’s Providers page links to this and related billing resources.
Q: Does the fee schedule affect whether I qualify for Medicaid?
A: No. The fee schedule only affects provider payments, not patient eligibility. Eligibility depends on income, household size, and category. Use a Medicaid Eligibility Calculator in 2026 to check your own situation.
Sources & Disclaimer
Written & Reviewed by Akash Biswas, MSW | Former Medicaid Caseworker Trainer | Verified against official Medicaid.gov and Alabama Medicaid Agency guidelines | Last Updated: August 2026
Sources:
- Alabama Medicaid Agency, Providers section — https://medicaid.alabama.gov/content/7.0_Providers/default.aspx
- Alabama Medicaid Agency, Fee Schedules / Provider Manuals — https://medicaid.alabama.gov/content/Gated/7.3G_Fee_Schedules.aspx
- KFF, Federal Matching Rate and Multiplier data — https://www.kff.org/medicaid/state-indicator/federal-matching-rate-and-multiplier/
- Medicaid.gov — https://www.medicaid.gov
- Healthcare.gov, Medicaid & CHIP overview — https://www.healthcare.gov/medicaid-chip/
CheckMedicaid.com is not affiliated with any government agency. This content is for educational purposes only. For official fee schedule rates, contact the Alabama Medicaid Agency or visit Medicaid.gov.
