The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 78431. 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
39
Median % of Medicare
--
Rate range
$55.17 - $3,999.01
78431 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alaska | $139.65 | -- | -- | 2026 |
| Arkansas | $109.46 | -- | -- | 2026 |
| Arizona | $705.06 | -- | -- | 2026 |
| California | $80.07 | -- | -- | 2026 |
| Colorado | $867.15 | -- | Required | 2026 |
| Connecticut | $1,497.46 | -- | -- | 2020 |
| District of Columbia | $75.29* | -- | Not required | 2026 |
| Delaware | $2,263.66 | -- | -- | 2026 |
| Iowa | $1,775.83 | -- | -- | 2024 |
| Idaho | $1,412.16 | -- | Required | 2026 |
| Illinois | $1,420.77 | -- | -- | 2024 |
| Indiana | $2,156.55 | -- | Required | 2025 |
| Kentucky | $74.08* | -- | Required | 2026 |
| Massachusetts | $64.60* | -- | -- | 2025 |
| Maine | $1,091.10 | -- | -- | 2026 |
| Michigan | $55.17* | -- | -- | 2026 |
| Minnesota | $481.40 | -- | -- | 2026 |
| Missouri | $2,025.45 | -- | Required | 2026 |
| Mississippi | $1,818.46 | -- | -- | 2026 |
| Montana | $117.57* | -- | -- | 2026 |
| North Dakota | $95.75* | -- | Not required | 2026 |
| Nebraska | $3,999.01 | -- | -- | 2026 |
| New Hampshire | $1,314.34 | -- | Not required | 2026 |
| New Jersey | $1,264.96 | -- | Not required | 2026 |
| New Mexico | $86.02 | -- | -- | 2023 |
| Nevada | $236.25 | -- | -- | 2024 |
| New York | $1,140.92 | -- | -- | 2026 |
| Ohio | $788.02 | -- | -- | 2024 |
| Oklahoma | $1,960.00 | -- | -- | 2026 |
| Oregon | $69.90* | -- | -- | 2026 |
| Rhode Island | $2,851.60 | -- | -- | 2026 |
| South Carolina | $64.24* | -- | -- | 2024 |
| Utah | $83.16* | -- | Not required | 2026 |
| Virginia | $74.94* | -- | -- | 2020 |
| Vermont | $72.40 | -- | -- | 2026 |
| Washington | $1,881.64 | -- | -- | 2026 |
| Wisconsin | $1,781.02 | -- | -- | 2020 |
| West Virginia | $1,483.03 | -- | -- | 2026 |
| Wyoming | $75.03 | -- | -- | 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 78431?
39 state Medicaid programs publish a fee-for-service rate for 78431 (heart PET/CT perfusion scan, rest and stress), ranging from $55.17 in Michigan to $3,999.01 in Nebraska. The full table on this page lists every publishing state's current rate.
Which state pays the most for 78431?
Nebraska publishes the highest Medicaid rate for 78431 at $3,999.01. Michigan publishes the lowest at $55.17.
Does 78431 require prior authorization under Medicaid?
5 of the 39 publishing states flag 78431 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".