Written & Reviewed by Akash Biswas, MSW | Former Medicaid Caseworker Trainer | Verified against official LDH and Medicaid.gov guidelines | Last Updated: March 2026
Louisiana Medicaid now pays doctors and providers at 85% of Medicare rates as of July 2025 — the biggest rate increase in a decade.
This rate structure remains in effect throughout 2026 and applies to physicians, nurse practitioners, and other eligible providers across the state.
This guide covers every major update to the Louisiana Medicaid fee schedule in 2026.
You’ll find current reimbursement rates, fee schedule format changes, managed care updates, and where to download official rate files.
Quick Summary
- Current rate baseline: 85% of March 2024 Region 99 Medicare rates (effective July 1, 2025)
- Budget impact: $258.4 million increase for the fiscal year ending June 30, 2026
- Covered providers: Physicians, nurse practitioners, certified nurse midwives, physician assistants, and clinical nurse specialists
- Fee schedule format: Transitioning from PDF to Excel-only format
- UnitedHealthcare exit: UHC leaves Louisiana Medicaid effective April 1, 2026
- Federal deadline: CMS requires full fee schedule transparency by July 1, 2026
What Is the Louisiana Medicaid Fee Schedule?
The Louisiana Medicaid fee schedule is the official list of payment rates the state pays providers for covered medical services.
The Louisiana Department of Health (LDH) publishes and maintains these rates.
Understanding the fee schedule helps providers know what they will be reimbursed for each service they deliver to Medicaid patients.
Louisiana does not publish one single “master” fee schedule. Instead, LDH maintains separate fee schedules across more than 25 service categories.
These include professional services, dental, ambulance, home health, hospice, behavioral health, DME, vision, pharmacy, and more.
How Louisiana Medicaid Sets Payment Rates
LDH sets most physician payment rates as a percentage of the federal Medicare rate.
3The current benchmark is 85% of the March 2024 Region 99 Medicare rate. Services already paid at or above this level stay the same.
State Plan Amendments (SPAs) and emergency rules authorize rate changes. The Louisiana Legislature funds these changes through the annual budget process.
Who Uses the Fee Schedule?
Doctors, hospitals, clinics, and other providers use the fee schedule to understand their Medicaid reimbursement.
Managed care organizations (MCOs) also reference it when negotiating payment contracts.
If you want to learn more about who qualifies for the program itself, see our guide on Louisiana Medicaid eligibility in 2026.
2026 Reimbursement Rate Baseline
The most important rate change affecting Louisiana Medicaid providers right now took effect on July 1, 2025.
This rate increase remains the governing payment structure for 2026.
Governor Jeff Landry confirmed in his March 9, 2026 legislative address that this increase is active and has brought more providers into the Medicaid network.
The 85% of Medicare Rate Increase
Act 306 of the 2024 Regular Legislative Session authorized this rate change. House Bill 1 of the 2025 Session funded it. Here are the key details:
- Rate level: 85% of March 2024 Region 99 Medicare rates
- Effective date: July 1, 2025 (still in effect)
- Implementation: Emergency rule published in the July 2025 Louisiana Register
- Budget cost: $258.4 million for the state fiscal year ending June 30, 2026
- Population served: Approximately 1.6 million Louisiana residents — about one-third of the state
LDH described this as one of the most comprehensive rate increases in a decade. All eligible claims with service dates on or after July 1, 2025 were automatically recycled.
Provider Payment Rules Still in Effect
Not all provider types receive the same rate. Here is how payment breaks down:
| Provider Type | Payment Rate |
|---|---|
| Physicians | 100% of the Medicaid fee schedule rate |
| Nurse Practitioners | 80% of the physician fee |
| Clinical Nurse Specialists | 80% of the physician fee |
| Certified Nurse Midwives | 80% of the physician fee (95% for pregnancy/childbirth) |
| Physician Assistants | 80% of the physician fee |
Exceptions: Physician-administered injections, LARCs, immunizations, and EPSDT preventive screenings are reimbursed at 100% for all listed provider types.
2026-Specific Fee Schedule and Coding Updates
LDH has issued several informational bulletins in early 2026 that directly change fee schedules and billing codes. Providers should review each bulletin that applies to their service area.
IB 26-1: School-Based Medicaid Program Changes (January 9, 2026)
This bulletin introduced procedure code changes specific to the School-Based Medicaid Program (SBMP) fee schedule.
Providers billing under SBMP should download the updated schedule from the LDH fee schedule index.
IB 26-2: 2026 HCPCS Update (January 14, 2026)
LDH released the annual update to Healthcare Common Procedure Coding System (HCPCS) codes.
This affects billing and fee schedule applicability across multiple service categories. Providers should verify that they are using the current codes for all 2026 claims.
IB 25-31: Behavioral Health Rate Revisions (Effective January 1, 2026)
Louisiana Medicaid updated the Specialized Behavioral Health Services (SBHS) fee schedule. Key changes include:
- ASAM Criteria 4th Edition changes apply to beneficiaries age 18 and older
- New rates and service definitions for behavioral health
- Room and Board rates were removed from the updated fee schedule
Take Charge Plus Fee Schedule (Effective January 1, 2026)
The fee schedule for Louisiana’s Take Charge Plus family planning program was also updated effective January 1, 2026.
Fee Schedule Format and Transparency Changes
Louisiana Medicaid is changing how it publishes fee schedules. These changes affect how providers access and use rate information.
The shift is driven by new federal CMS payment rate transparency requirements.
Transition From PDF to Excel Format
Starting in May 2025, LDH began publishing fee schedules exclusively in Excel format.
The traditional PDF format is being phased out. Excel files allow providers to sort, filter, and search rate data more easily.
New Data Fields
Updated fee schedules now include additional fields:
- An indicator showing when a procedure code was added or modified
- The date of the change
- The effective date of service for new fees
Modernized legends are being published as separate documents. These describe the fields within each fee schedule file.
Federal CMS Transparency Deadline: July 1, 2026
CMS requires all states to post complete Medicaid fee schedules online by July 1, 2026. States must update them within one month of approval.
The schedules must also include Medicaid-to-Medicare rate comparisons.
Louisiana has signaled its intent to comply.
However, as of March 2026, the fully compliant Excel-format schedules have not yet been confirmed as published.
Managed Care Organization Changes in 2026
Major changes to Louisiana’s Medicaid managed care landscape affect how MCOs set provider payment rates.
These changes also impact which health plans are available to the state’s 1.6 million Medicaid members.
To see how income limits connect to plan enrollment, check our breakdown of Louisiana Medicaid income limits in 2026.
UnitedHealthcare Exit (Effective April 1, 2026)
LDH did not renew its contract with UnitedHealthcare. After a 90-day extension (IB 25-35), UHC is no longer available to Louisiana Medicaid members as of April 1, 2026.
Current UHC members were given a special enrollment period from January 15 to February 15, 2026 to choose a new MCO. Members who did not choose were auto-assigned to another plan.
Remaining MCOs for 2026
Five managed care organizations serve Louisiana Medicaid members in 2026:
- Aetna Better Health
- AmeriHealth Caritas Louisiana
- Healthy Blue
- Humana
- Louisiana Healthcare Connections
Provider Transition Rules
MCOs receiving former UHC members must honor existing provider relationships for a 60-day transition period.
This applies to both in-network and out-of-network providers.
The Joint Legislative Committee on the Budget granted LDH authority to extend existing MCO contracts for an additional year through 2026.
2026 Income Eligibility Standards
While this article focuses on provider fee schedules, it helps to know the income limits that determine who qualifies for Louisiana Medicaid.
These limits took effect March 1, 2026. For a full state-by-state comparison, visit our guide to Medicaid income limits by state in 2026.
Monthly Income Limits (Household of 4)
| Program | Monthly Income Limit |
|---|---|
| Medicaid Expansion (Ages 19–64) | $3,795 |
| LaCHIP (Children) | $5,968 |
| LaCHIP Affordable Plan | $7,013 |
| Family Opportunity Act (Children with Disabilities) | $8,250 |
These figures come directly from the Louisiana Department of Health. Income is calculated using Modified Adjusted Gross Income (MAGI) for most applicants.
Pharmacy and Billing Changes in 2026
Two important billing changes affect pharmacy providers and 340B entities. Providers must follow these rules to avoid billing errors or penalties.
340B Drug Pricing Program (Effective January 1, 2026)
IB 25-27 introduced new billing requirements for 340B pharmacies and covered entities. Intentionally including an incorrect claim-level modifier is now classified as improper Medicaid billing. This rule was revised as recently as February 24, 2026.
Pharmacy Benefit Management
Changes to Medicaid Pharmacy Benefit Management became effective October 1, 2025 under IB 25-25. These rules remain in force through 2026. The professional dispensing fee for drugs dispensed to Louisiana Medicaid enrollees is $10.00.
Confirmed Data Gaps as of March 2026
Some fee schedule information has not yet been confirmed for 2026. Providers should be aware of these gaps and check official LDH sources regularly.
What Has NOT Been Updated Yet
- No new across-the-board rate change for 2026. The July 2025 increase (85% of Medicare) remains in effect. No new adjustment has been announced for FY2027.
- No 2026 Medicare parity update. The federal CY 2026 Medicare Physician Fee Schedule includes conversion factor changes, but Louisiana has not announced a corresponding Medicaid adjustment.
- DME fee schedule. The fee schedule index lists 2025 effective dates for some DME archives. A specific 2026 update has not been posted yet. Providers should use the most recent 2025 version.
- CMS transparency compliance. The July 1, 2026 deadline is approaching. Louisiana has not yet published the fully compliant fee schedules with Medicaid-to-Medicare rate comparisons.
Where to Access Official Fee Schedules
All current Louisiana Medicaid fee schedules are published at these official locations.
For a broader look at how Medicaid fee schedules work in 2026 across the country, see our national guide.
Official LDH Links
- Fee Schedule Index: lamedicaid.com/provweb1/fee_schedules/feeschedulesindex.htm
- Claims and Billing: ldh.la.gov/medicaid/claims-and-billing
- Informational Bulletins: ldh.la.gov/medicaid/informational-bulletins
- Medicaid Policy Gateway: ldh.la.gov/medicaid/medicaid-policy-gateway
Provider Contact Numbers
- Medicaid Customer Service: 1-888-342-6207
- Healthy Louisiana: 1-855-229-6848
FAQ
Q: What is the current Louisiana Medicaid reimbursement rate for physicians in 2026?
A: Louisiana Medicaid pays physicians at 85% of March 2024 Region 99 Medicare rates. This increase took effect July 1, 2025 and remains active through 2026. It was authorized by Act 306 of the 2024 Regular Legislative Session and applies to eligible physician services statewide.
Q: Has Louisiana released a new Medicaid fee schedule specifically for 2026?
A: Louisiana has not released a new across-the-board fee schedule for 2026. The July 2025 rate increase remains the current baseline. However, LDH has issued 2026-specific updates for behavioral health, school-based programs, and HCPCS coding through informational bulletins.
Q: What format are Louisiana Medicaid fee schedules published in now?
A: LDH is transitioning all fee schedules from PDF to Excel-only format. This change began in May 2025. Excel files include new data fields showing when codes were added or changed. The traditional PDF format is being phased out for most schedule categories.
Q: Which managed care organizations serve Louisiana Medicaid in 2026?
A: Five MCOs serve Louisiana Medicaid members in 2026: Aetna Better Health, AmeriHealth Caritas Louisiana, Healthy Blue, Humana, and Louisiana Healthcare Connections. UnitedHealthcare exited effective April 1, 2026 after LDH chose not to renew its contract.
Q: How much does Louisiana Medicaid pay nurse practitioners compared to physicians?
A: Nurse practitioners receive 80% of the physician fee schedule rate for most services. Exceptions include physician-administered injections, LARCs, immunizations, and EPSDT preventive screenings — these are reimbursed at 100%. Certified nurse midwives receive 95% for pregnancy and childbirth services.
Q: When is the federal deadline for Medicaid fee schedule transparency?
A: CMS requires all states to post complete Medicaid fee schedules online by July 1, 2026. Schedules must include Medicaid-to-Medicare rate comparisons and be updated within one month of approval. Louisiana has indicated it will comply but has not yet published the fully compliant versions.
Sources
- Louisiana Department of Health Press Release (Jul 29, 2025): ldh.la.gov/news/7537
- LDH Informational Bulletin 25-20 (Aug 8, 2025): ldh.la.gov/assets/docs/BayouHealth/Informational_Bulletins/2025/IB25-20.pdf
- LDH Fee Schedule Index: lamedicaid.com/provweb1/fee_schedules/feeschedulesindex.htm
- LDH Informational Bulletins: ldh.la.gov/medicaid/informational-bulletins
- LDH — Changes to Medicaid Health Plans in 2026: ldh.la.gov/medicaid/medicaid2026
Disclaimer: CheckMedicaid.com is not affiliated with any government agency. This content is for educational purposes only. For official fee schedules and reimbursement rates, contact the Louisiana Department of Health or visit lamedicaid.com.
