New York has not released one full 2027 Medicaid fee schedule yet. There’s no single document listing 2027 dollar amounts for every provider type.
But that doesn’t mean nothing is happening. The state has already locked in some real rate changes that apply during 2027. Hospitals get a confirmed pay bump. State budget documents show new funding for physicians and clinics. And a federal agreement could force more rate hikes before spring 2027.
This guide breaks down exactly what’s confirmed, what’s still pending, and where to check for updates. All information below is sourced from official New York State Department of Health (NYSDOH) and Centers for Medicare & Medicaid Services (CMS) documents, current as of August 20, 2026.
Article Summary
- New York has not published a complete 2027 Medicaid fee schedule as of August 2026.
- Hospital outpatient services get a confirmed 10% rate increase, running from March 1, 2025 through March 31, 2028.
- The state budget sets aside $50 million for physician fee investments and $10 million for clinic investments in FY2027.
- A federal demonstration agreement could require added rate hikes if Medicaid pay falls too far below Medicare rates.
- That federal demonstration period ends March 31, 2027.
- No 2027 fee tables exist yet for physicians, dentists, nursing homes, home care, or hospital inpatient services.
What Is the NY Medicaid Fee Schedule?
The Medicaid fee schedule is the list of dollar amounts New York pays providers for covered services. Doctors, hospitals, clinics, and other providers use it to bill Medicaid correctly.
New York updates these fee schedules through state budget actions, State Plan Amendments (SPAs), and federal waiver agreements. Rates can change mid-year, and different provider types are often updated on separate timelines.
For FY2027 specifically, the picture is mixed. Some rate policies are locked in. Others are still working through the approval process.
Confirmed Hospital Outpatient Rate Increase
Hospitals have the clearest news so far. New York’s State Plan Amendment (SPA) 25-0027 sets a 10% across-the-board increase to the operating component of Medicaid reimbursement for specified hospital outpatient services.
The increase covers dates of service from March 1, 2025 through March 31, 2028.
That means the increase is already active and will stay in effect through all of calendar year 2027.
The SPA names specific categories that qualify for the increase:
| Covered Category | Applies To |
|---|---|
| APG rate computation | Hospital outpatient services |
| Hospital-based APG base-rate table | Outpatient billing |
| Hospital-based primary care | Physician services provided offsite |
| Exempt acute-care children’s hospitals | Pediatric hospital services |
You can read the full SPA on the NYSDOH website.
Physician and Clinic Budget Investments for FY2027
New York’s budget scorecard shows real dollars set aside for FY2027, even though a code-by-code fee schedule hasn’t been released.
Physician Fee Schedule Investment
The 2026 Enacted Budget Medicaid Scorecard lists $50.0 million in state-share Physician Fee Schedule Investments for FY 2027, with an effective date of April 1, 2025.
This confirms funding exists. It does not confirm a specific percentage increase for any individual CPT or HCPCS code.
Clinic Investment
The same budget document identifies $10.0 million in state-share clinic investments for FY 2027, effective April 1, 2025. Again, this is a funding allocation, not a finished rate table.
You can review the full breakdown on the NYSDOH Enacted Budget Scorecard page.
Could Federal Rules Force More Rate Increases?
Yes, possibly. New York operates under an approved Medicaid Redesign Team Section 1115 demonstration with CMS. This agreement includes a built-in trigger for rate increases.
Here’s how it works. If New York’s Medicaid-to-Medicare payment ratio drops below 80% for primary care, behavioral health, or obstetrics, the state must raise both fee-for-service and managed-care rates in that category.
When the trigger applies, New York must:
- Increase the affected rates by at least two percentage points.
- Reach a combined total of $199,072,125 in net provider-rate increases by the end of the demonstration period.
- Choose its own timing for the increases.
- Optionally direct extra funds toward specialty services like dental care, if core categories already meet the target.
The current demonstration period ends March 31, 2027. This agreement does not guarantee a rate-ratio trigger will fire in 2027, and it does not create a full calendar-year fee schedule on its own.
Full details are in the CMS approval letter.
What’s Still Missing for 2027
Several fee schedules that providers rely on every year have not been released for 2027. Do not assume prior-year numbers will carry over unchanged. These include:
- A statewide physician fee-for-service schedule by CPT/HCPCS code.
- A statewide dental fee-for-service schedule.
- An updated APG fee schedule for hospital outpatient, clinic, and behavioral health services. The current posted history only goes through January 1, 2025.
- A mental hygiene APG fee schedule for 2027. The posted rates are still effective April 1, 2024, and some fees remain pending CMS and state budget approval.
- Rate tables for nursing facilities, home care, FQHCs/RHCs, ambulatory surgery centers, hospital inpatient services, and managed-care capitation rates.
If your practice bills Medicaid for any of these services, keep checking official sources rather than relying on last year’s numbers.
Where to Check for Official 2027 Updates
New York’s Division of Finance and Rate Setting is the official state office for Medicaid fee-for-service rates, covering hospitals, clinics, nursing homes, home care, and mental hygiene services. Bookmark their rate-setting page and check it periodically as 2027 approaches.
The Enacted Budget Scorecard is also useful for funding context, but remember it shows budget totals, not claim-level fee amounts.
This article reflects official New York State and federal sources current as of August 20, 2026. Medicaid rates vary by state, and federal Medicaid rules set minimum standards that states can build on. Check official .gov sources directly before making billing or coverage decisions, since rate schedules can change.
Frequently Asked Questions
Is there a full 2027 NY Medicaid fee schedule yet?
No. As of August 2026, New York has not published a complete fee schedule with 2027 dollar amounts across all provider types. Some rate policies, like the hospital outpatient increase, are confirmed and already active.
Did NY Medicaid rates go up for 2027?
Hospital outpatient services have a confirmed 10% operating rate increase through March 2028. Physician and clinic services have budget funding set aside, but no confirmed per-code increase yet.
When does the current Medicaid rate demonstration end?
The approved Section 1115 demonstration period ends March 31, 2027. It may require added rate increases if Medicaid pay falls too far below Medicare levels.
Will my provider’s Medicaid payment change in 2027?
It depends on your service type. Hospital outpatient providers have a confirmed increase. Other provider types should check NYSDOH’s rate-setting page directly, since schedules are released on different timelines.
Where can I find official Medicaid rate updates for New York?
Use the NYSDOH Division of Finance and Rate Setting page. It’s the state’s official source for fee-for-service rate schedules.
Does the physician fee investment mean my CPT code payment went up?
Not automatically. The $50 million investment confirms funding exists for FY2027, but NYSDOH has not released a code-by-code rate table showing individual payment changes yet.
What to Do Next
If you bill NY Medicaid, don’t wait for a single announcement. Check NYSDOH’s rate-setting page directly for your provider type, and confirm any 2027 numbers before you use them for billing or budgeting.
