The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 77520. 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
30
Median % of Medicare
--
Rate range
$34.85 - $1,129.65
77520 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $803.84* | -- | -- | 2026 |
| Arkansas | $924.22 | -- | -- | 2026 |
| Arizona | $929.94 | -- | -- | 2020 |
| Colorado | $82.97 | -- | Required | 2026 |
| Connecticut | $636.02 | -- | -- | 2026 |
| Georgia | $262.40 | -- | -- | 2026 |
| Iowa | $69.56 | -- | -- | 2024 |
| Idaho | $724.77 | -- | Not required | 2025 |
| Illinois | $1,129.65 | -- | -- | 2024 |
| Indiana | $625.68 | -- | -- | 2026 |
| Kansas | $532.63 | -- | -- | 2024 |
| Kentucky | $232.17 | -- | -- | 2026 |
| Louisiana | $34.85 | -- | -- | 2026 |
| Michigan | $295.24 | -- | -- | 2026 |
| Minnesota | $749.00 | -- | -- | 2026 |
| Missouri | $494.24 | -- | Varies | 2022 |
| Mississippi | $763.02 | -- | -- | 2026 |
| Montana | $330.07 | -- | -- | 2026 |
| New Jersey | $474.74 | -- | Not required | 2026 |
| New Mexico | $1,064.49 | -- | -- | 2025 |
| Ohio | $671.56 | -- | -- | 2018 |
| Oklahoma | $553.33 | -- | -- | 2026 |
| Rhode Island | $1,033.67 | -- | -- | 2026 |
| South Carolina | $448.08 | -- | -- | 2026 |
| Texas | $779.02* | -- | -- | 2024 |
| Utah | $123.89* | -- | Not required | 2026 |
| Virginia | $856.22 | -- | -- | 2011 |
| Washington | $569.60 | -- | -- | 2026 |
| Wisconsin | $524.65 | -- | -- | 2008 |
| West Virginia | $675.37 | -- | -- | 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 77520?
30 state Medicaid programs publish a fee-for-service rate for 77520 (proton radiation delivery, simple, no compensator), ranging from $34.85 in Louisiana to $1,129.65 in Illinois. The full table on this page lists every publishing state's current rate.
Which state pays the most for 77520?
Illinois publishes the highest Medicaid rate for 77520 at $1,129.65. Louisiana publishes the lowest at $34.85.
Does 77520 require prior authorization under Medicaid?
1 of the 30 publishing states flag 77520 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".