Kentucky Medicaid MNT coverage: codes and limits
The short answerKentucky's 2026 Medicaid physician fee schedule lists 97802, 97803 and 97804 with rates: $11.87 per 15 minutes for 97802 and 97803, and $4.64 per 30 minutes for 97804. No prior authorization is marked. The schedule says a listed code and rate is not a guarantee of coverage or payment, and it does not say who may bill.
By Javier Alvarez · Updated · 1 min read
1 row: Medicaid (by state) · Kentucky. Public policy, not the member's benefits.
Kentucky Medicaid
Medicaid (DMS Physician Fee Schedule 2026) · Kentucky
| 97802 | Listed (on the physician fee schedule at $11.87 per 15 minutes. Listing is not a guarantee of coverage.) [1] |
|---|---|
| 97803 | Listed (on the physician fee schedule at $11.87 per 15 minutes. Listing is not a guarantee of coverage.) [1] |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Physician Fee Schedule, effective January 1, 2026, revised 10.27.2026. [1] |
| Diagnoses | Not published: call the payer. |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | The Prior Auth Required column is blank for 97802, 97803 and 97804. [1] |
| Referral and prior auth | Not published: call the payer. |
| Payment | 97802 $11.87 and 97803 $11.87 (each 15 minutes); 97804 $4.64 (each 30 minutes). Facility and non-facility amounts are the same. [1] |
| Also | The schedule states: the appearance of a code and rate is not a guarantee of coverage nor payment. Advanced practice registered nurses and physician assistants receive 75% of the physician rate. [1] |
- Kentucky DMS: Physician Fee Schedule 2026 (effective January 1, 2026, revised 10.27.2026), checked October 30, 2026
Check a Medicaid claim against the row
Before a Kentucky Medicaid claim goes out, compare it with the row above: the code is one the policy lists, the place of service and modifier match for a video visit, and the units fit the limit. Change the filters to compare Medicaid with another payer, then download the PDF of what you see.