The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 77525. 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
$43.07 - $3,786.64
77525 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $3,786.64 | -- | -- | 2026 |
| Arkansas | $964.10 | -- | -- | 2026 |
| Arizona | $1,205.73 | -- | -- | 2020 |
| Colorado | $3,170.64 | -- | -- | 2026 |
| Connecticut | $825.12 | -- | -- | 2026 |
| Georgia | $516.33 | -- | -- | 2026 |
| Iowa | $658.80 | -- | -- | 2024 |
| Idaho | $939.71 | -- | Not required | 2025 |
| Illinois | $1,351.50 | -- | -- | 2024 |
| Indiana | $865.50 | -- | -- | 2024 |
| Kansas | $691.21 | -- | -- | 2024 |
| Kentucky | $671.38 | -- | -- | 2026 |
| Louisiana | $43.07 | -- | -- | 2026 |
| Michigan | $667.77 | -- | -- | 2026 |
| Minnesota | $964.87 | -- | -- | 2026 |
| Missouri | $590.63 | -- | Varies | 2022 |
| Mississippi | $969.56 | -- | -- | 2026 |
| Montana | $336.43 | -- | -- | 2026 |
| New Jersey | $615.50 | -- | Not required | 2026 |
| New Mexico | $1,277.65 | -- | -- | 2025 |
| Oklahoma | $661.25 | -- | -- | 2026 |
| Rhode Island | $1,235.28 | -- | -- | 2026 |
| South Carolina | $903.80 | -- | -- | 2026 |
| Texas | $1,010.02* | -- | -- | 2024 |
| Utah | $358.26* | -- | Not required | 2026 |
| Virginia | $1,120.04 | -- | -- | 2011 |
| Washington | $738.52 | -- | -- | 2026 |
| Wisconsin | $850.00 | -- | -- | 2008 |
| West Virginia | $910.12 | -- | -- | 2026 |
| Wyoming | $1,135.68 | -- | -- | 2020 |
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 77525?
30 state Medicaid programs publish a fee-for-service rate for 77525 (proton radiation delivery, complex), ranging from $43.07 in Louisiana to $3,786.64 in Alabama. The full table on this page lists every publishing state's current rate.
Which state pays the most for 77525?
Alabama publishes the highest Medicaid rate for 77525 at $3,786.64. Louisiana publishes the lowest at $43.07.
Does 77525 require prior authorization under Medicaid?
No publishing state flags 77525 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.