EPSDT Preventive Services Rate Update CPT® 99385 and CPT® 99395 Retroactive Effective Date: October 16, 2025
Date: 01/21/26
The Louisiana Department of Health (LDH) has confirmed a corrective Medicaid reimbursement increase for two EPSDT preventive medicine services that were not included in the EPSDT rate updates implemented in October 2025.
These updated rates will be implemented shortly and applied retroactively.
| CPT Code | Description | New Medicaid Rate |
|---|---|---|
| 99385 | Initial comprehensive preventive E/M, new patient (ages 18–39) | $80.17 |
| 99395 | Periodic comprehensive preventive E/M, established patient (ages 18–39) | $69.69 |
Claims with dates of service on or after October 16, 2025, that were previously paid at lower rates will be automatically reprocessed. No action is required from providers.