The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 64616. Full schedules include every locality, modifier, and age-band variant.
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Publishing states
47
Median % of Medicare
75%
Rate range
$63.47 - $776.00
64616 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $66.81 | 46.5% | -- | 2026 |
| Arkansas | $138.61 | 96.5% | -- | 2026 |
| Arizona | $143.02 | 99.6% | -- | 2022 |
| California | $90.47 | 63% | -- | 2026 |
| Colorado | $111.16 | 77.4% | -- | 2026 |
| Connecticut | $87.84 | 61.2% | -- | 2026 |
| District of Columbia | $129.54 | 90.2% | Required | 2026 |
| Delaware | $138.76 | 96.6% | -- | 2026 |
| Florida | $77.41 | 53.9% | -- | 2026 |
| Georgia | $105.32 | 73.3% | -- | 2026 |
| Hawaii | $108.83 | 75.8% | -- | 2025 |
| Iowa | $92.21 | 64.2% | -- | 2024 |
| Idaho | $111.16 | 77.4% | Not required | 2026 |
| Illinois | $75.77 | 52.8% | -- | 2024 |
| Indiana | $122.96 | 85.6% | -- | 2025 |
| Kansas | $79.81 | 55.6% | -- | 2024 |
| Kentucky | $94.60 | 65.9% | -- | 2026 |
| Louisiana | $111.09 | 77.3% | -- | 2026 |
| Massachusetts | $103.10 | 71.8% | -- | 2025 |
| Maine | $94.95 | 66.1% | -- | 2026 |
| Michigan | $63.47 | 44.2% | -- | 2026 |
| Minnesota | $103.17 | 71.8% | -- | 2026 |
| Missouri | $103.69 | 72.2% | Not required | 2022 |
| Mississippi | $233.10 | -- | -- | 2026 |
| Montana | $189.77 | 132.1% | -- | 2026 |
| North Carolina | $96.19 | 67% | -- | 2025 |
| North Dakota | $150.20 | 104.6% | Not required | 2026 |
| Nebraska | $177.84 | 123.8% | -- | 2026 |
| New Hampshire | $72.24 | 50.3% | Not required | 2026 |
| New Jersey | $73.31 | 51% | Not required | 2026 |
| New Mexico | $200.52 | 139.6% | -- | 2025 |
| Nevada | $130.62 | 90.9% | -- | 2024 |
| New York | $129.61 | 90.2% | -- | 2026 |
| Ohio | $97.48 | 67.9% | -- | 2024 |
| Oklahoma | $123.68 | 86.1% | -- | 2026 |
| Oregon | $113.00* | 78.7% | -- | 2026 |
| Pennsylvania | $776.00* | -- | -- | 2014 |
| Rhode Island | $270.13 | -- | -- | 2026 |
| South Carolina | $90.88 | 63.3% | -- | 2024 |
| Texas | $112.00* | 78% | -- | 2025 |
| Utah | $107.77* | 75% | Not required | 2026 |
| Virginia | $124.42 | 86.6% | -- | 2026 |
| Vermont | $115.03 | 80.1% | -- | 2026 |
| Washington | $85.42 | 59.5% | -- | 2026 |
| Wisconsin | $106.18 | 73.9% | -- | 2018 |
| West Virginia | $102.24 | 71.2% | -- | 2026 |
| Wyoming | $118.04 | 82.2% | -- | 2026 |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * are representative published variants or methodology-derived rates. "--" in the prior-auth column means the state publishes no PA flag.
Related physician codes
- 10021 - Fine needle aspiration biopsy, first lesion, no imaging
- 10060 - Drainage of a skin abscess, simple
- 10061 - Drainage of a skin abscess, complicated or multiple
- 10080 - Drainage of a pilonidal cyst, simple
- 10081 - Drainage of a pilonidal cyst, complicated
- 10120 - Removal of a foreign body from tissue, simple
- 10121 - Removal of a foreign body from skin, complicated
- 10140 - Drainage of a blood or fluid collection under the skin
Frequently asked questions
How much does Medicaid pay for 64616?
47 state Medicaid programs publish a fee-for-service rate for 64616 (botulinum toxin injection into neck muscles), ranging from $63.47 in Michigan to $776.00 in Pennsylvania, with a median of 75% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for 64616?
Pennsylvania publishes the highest Medicaid rate for 64616 at $776.00. Michigan publishes the lowest at $63.47.
Does 64616 require prior authorization under Medicaid?
1 of the 47 publishing states flag 64616 as requiring prior authorization (always or conditionally) on their fee schedules. States without a flag publish no PA indicator for this code - that means "not published", not "no PA required".