The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 77399. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
- Full-schedule CSV export
- Full state Medicaid dental network lists
- Email alerts when a state changes its rates
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Publishing states
12
Median % of Medicare
--
Rate range
$41.52 - $219.73
77399 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arkansas | $69.88* | -- | -- | 2026 |
| Arizona | $41.52 | -- | -- | 2026 |
| Idaho | $62.57* | -- | Not required | 1979 |
| Kentucky | $71.81 | -- | -- | 2026 |
| Louisiana | $219.73 | -- | -- | 2026 |
| Michigan | $71.82 | -- | -- | 2026 |
| Missouri | $80.60 | -- | Not required | 2022 |
| Mississippi | $102.07 | -- | -- | 2026 |
| Montana | $130.22 | -- | -- | 2026 |
| New Mexico | $113.12 | -- | -- | 2026 |
| Rhode Island | $168.59 | -- | -- | 2026 |
| South Carolina | $163.69 | -- | -- | 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 lab & imaging codes
- 70030 - X-ray of the eye for a foreign body
- 70100 - Jaw (mandible) X-ray, up to 3 views
- 70110 - Jaw (mandible) X-ray, 4 or more views
- 70120 - X-ray of the mastoids, under 3 views per side
- 70130 - X-ray of the mastoids, complete
- 70134 - X-ray of the inner ear canals, complete
- 70140 - Facial bone X-ray, under 3 views
- 70150 - Facial bone X-ray, complete, 3 or more views
Frequently asked questions
How much does Medicaid pay for 77399?
12 state Medicaid programs publish a fee-for-service rate for 77399 (unlisted radiation physics or dosimetry service), ranging from $41.52 in Arizona to $219.73 in Louisiana. The full table on this page lists every publishing state's current rate.
Which state pays the most for 77399?
Louisiana publishes the highest Medicaid rate for 77399 at $219.73. Arizona publishes the lowest at $41.52.
Does 77399 require prior authorization under Medicaid?
No publishing state flags 77399 with a prior-authorization indicator on its fee schedule. Absence of a flag means the state publishes none, not that PA is never required - confirm through the state's provider manual.