Written & Reviewed by Akash Biswas, MSW | Former Medicaid Caseworker Trainer | Verified against official Medicaid.gov and Wyoming Department of Health guidelines | Last Updated: June 2026
As of mid-2026, Wyoming has not released one single “Master Fee Schedule” PDF. Instead, rates are split across provider manuals, an online fee-schedule index, and the secure provider portal.
This guide walks you through the confirmed 2026 rate changes, key dates, and exactly where to find official numbers.
Quick Summary:
- Wyoming Medicaid fee rates live in separate manuals, not one combined document
- Maternal health rates go up on July 1, 2026, under House Bill 0064
- A new School Based Services Manual started April 1, 2026
- Providers must use the secure portal or manuals to see exact CPT/HCPCS rates
- For numbers from other states, check Medicaid income limits by state in 2026
What Is the Wyoming Medicaid Fee Schedule?
A fee schedule is a list of prices. It shows the most a doctor, clinic, or other provider can get paid for each service under Medicaid. Wyoming uses procedure codes, called CPT or HCPCS codes, to match each service to its maximum rate.
Wyoming does not post these dollar amounts on one public page. Instead, the state’s fee-schedule index links out to category pages, and many exact rates only show up once a provider logs into the secure portal.
Why Wyoming Splits Its Fee Schedule
Wyoming groups its rates by provider type. This includes physician services, dental, vision, therapies, behavioral health, and more. Splitting the schedule this way lets the state update one category without rewriting the whole document.
Who Uses the Fee Schedule
Providers use the fee schedule to bill correctly and avoid claim denials. Patients rarely need these exact numbers, but knowing they exist helps you understand how your care gets paid for.
Key 2026 Fee Schedule Updates and Rate Changes
Wyoming confirmed several rate changes for 2026 through legislative action and provider manual updates. Each change has its own effective date and purpose. Here are the three biggest updates providers and patients should know.
Maternal Health Rate Increase (Effective July 1, 2026)
Wyoming authorized higher reimbursement rates for obstetrician-gynecologists, family physicians who provide obstetrical care, and midwives. The goal is to improve access to prenatal, labor, and postpartum care, especially in rural and frontier parts of the state. House Bill 0064 (2026) funds these increases with state and federal dollars from July 1, 2026, through June 30, 2028.
School-Based Services (Effective April 1, 2026)
A new School Based Services Manual took effect on April 1, 2026. This manual sets the rules and allowed fees for medical services delivered inside schools. It applies to providers who bill Medicaid for care given in an educational setting.
Nursing Home Penalty Rate (2026 Estimate)
The average monthly private-pay nursing home rate is estimated at about $8,500 per month for 2026 in Wyoming. This number is not a direct payment rate. Instead, it is used to calculate penalty periods during Medicaid’s long-term care look-back review.
Critical Dates for Wyoming Medicaid Providers in 2026
Several dates matter for anyone billing Wyoming Medicaid this year. Missing one of these could affect how and when you get paid. The table below lists the confirmed dates and what each one means.
| Date | Event | Impact |
|---|---|---|
| April 1, 2026 | School Based Services Update | New manual and fee structure takes effect for school providers |
| July 1, 2026 | Maternal Health Increases | Enhanced rates begin for OB/GYN and midwifery services |
| July 1, 2026 | Federal Transparency Deadline | Federal rules require states to publish accessible fee-for-service rate schedules |
| July 4, 2026 | Payment Exception | Payment cycles shift due to the holiday week (confirmed in a June 18, 2026 notice) |
Why the July 1 Federal Deadline Matters
Federal rules push states to make fee-for-service rates easier to find. This could lead Wyoming to release a new public dashboard or document later in 2026. Watch the official fee-schedule index for changes after this date.
How to Access Official 2026 Fee Schedule Rates
Because Wyoming does not publish one combined rate sheet, you need to know where to look. There are three main official channels. Each one works best for a different need.
Secure Provider Portal
Active providers can log into the Wyoming Medicaid Provider Portal to see exact reimbursement rates for specific CPT and HCPCS codes. This is the most reliable source for current, code-level pricing. Access requires an approved provider account.
Provider Manuals and Bulletins
Fee schedules often appear as appendices or tables inside specific provider manuals, such as Dental, Behavioral Health, or Title 25 manuals. Look for a “Chapter 6” or “Reimbursement” section in the manual for your provider type. The Provider Manuals and Bulletins page is the starting point for these documents.
Title 25 Behavioral Health Manual
Updates on involuntary hospitalization services usually appear in the Title 25 Provider Manual. A 2026 update is expected, so behavioral health providers should check this manual’s Behavioral Health Manuals section directly for the latest version.
What the Official 2026 Fee Schedule Page Confirms
Wyoming’s Department of Health, Division of Healthcare Financing, runs the official fee-schedule index at health.wyo.gov. This page does not list dollar amounts directly. Instead, it links to category-specific schedules and was last reviewed on January 1, 2026.
Categories Listed on the Index
The page lists many service categories, including physician services, APN, nurse practitioner, physician assistant, CRNA, midwife, podiatry, dental, vision, therapies, behavioral health, FQHC and RHC, hospital and facility services, pharmacy, DME, lab, radiology, ambulance, transportation, and interpretation services. Each category links to its own schedule rather than showing rates inline.
State Plan Update for July 1, 2026
A State Plan public notice, dated June 4, 2026, confirms Wyoming proposed updating Attachment 4.19 to reflect fee schedule changes effective July 1, 2026. This update still needs approval from the Centers for Medicare and Medicaid Services (CMS) before it becomes final.
What’s Still Missing
The public index does not show actual 2026 fee amounts in its page text. The State Plan notice confirms an effective date but does not publish the rate tables themselves. Full line-item amounts currently require either a provider manual or portal access.
Wyoming Medicaid Eligibility and How It Affects Fee Schedules
Wyoming has not expanded Medicaid under the Affordable Care Act as of mid-2026. This means eligibility stays limited to specific groups, such as low-income children, pregnant women, elderly residents, and people with disabilities. A smaller eligible population affects how many billable services general practitioners can provide under these fee schedules.
If you want to know whether you or a family member qualifies, our guide on Medicaid Eligibility breaks down the groups Wyoming covers. You can also compare Wyoming’s limited eligibility rules against other states using our Medicaid income limits by state in 2026 chart.
How Limited Expansion Shapes Provider Volume
Because fewer adults qualify without expansion, providers see a narrower mix of Medicaid patients than in expansion states. This can influence which fee categories, like maternal health or pediatric care, see the most billing activity.
FAQ
Q: Does Wyoming have one official 2026 Medicaid fee schedule document?
A: No. As of mid-2026, Wyoming splits its fee schedule across an online index, provider manuals, and the secure provider portal. There is no single downloadable master document with all rates listed together.
Q: When do Wyoming’s maternal health rate increases start?
A: Enhanced rates for OB/GYNs, family physicians providing obstetrical care, and midwives begin July 1, 2026. House Bill 0064 funds this increase through June 30, 2028, to improve rural maternal care access.
Q: How can a provider see exact Wyoming Medicaid reimbursement rates?
A: Active providers should log into the Wyoming Medicaid Provider Portal for code-level rates. Providers can also check Chapter 6 or the Reimbursement section of their specific provider manual.
Q: What changed for school-based Medicaid services in 2026?
A: A new School Based Services Manual took effect April 1, 2026. It sets the reimbursement rules and allowed fees for medical services provided inside Wyoming schools.
Q: Has Wyoming expanded Medicaid under the Affordable Care Act?
A: No, Wyoming has not expanded Medicaid as of mid-2026. Eligibility stays limited to specific groups, including low-income children, pregnant women, elderly residents, and people with disabilities.
Q: What is the 2026 nursing home rate used for Medicaid penalty periods?
A: Wyoming estimates the average monthly private-pay nursing home rate at about $8,500 for 2026. This figure helps calculate look-back penalty periods, not direct provider payments.
Sources & Disclaimer
Last Updated: June 2026
Sources:
- Wyoming Medicaid & Kid Care CHIP Fee Schedules, Wyoming Department of Health, Division of Healthcare Financing — health.wyo.gov/healthcarefin/medicaid/fee-schedules/
- Wyoming Medicaid State Plan, public notice on fee schedule effective dates (June 4, 2026) — health.wyo.gov/healthcarefin/medicaid/spa/
- Wyoming House Bill 0064 (2026), legislative text on maternal health rate funding
Disclaimer: CheckMedicaid.com is not affiliated with any government agency. This content is for educational purposes only. For official eligibility and rate information, contact your state Medicaid office or visit Medicaid.gov.
