The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 81330. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
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Publishing states
30
Median % of Medicare
100%
Rate range
$28.20 - $158.09
81330 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alaska | $47.00 | 100% | -- | 2026 |
| Arkansas | $158.02 | 336.2% | -- | 2026 |
| Arizona | $47.00 | 100% | -- | 2026 |
| Connecticut | $32.90 | 70% | Required | 2018 |
| Delaware | $46.06 | 98% | -- | 2026 |
| Georgia | $98.40 | 209.4% | -- | 2026 |
| Hawaii | $28.20 | 60% | -- | 2025 |
| Illinois | $32.01 | 68.1% | -- | 2024 |
| Indiana | $47.00 | 100% | Required | 2018 |
| Kansas | $158.09 | 336.4% | -- | 2013 |
| Kentucky | $47.00 | 100% | -- | 2026 |
| Massachusetts | $41.45 | 88.2% | -- | 2024 |
| Maine | $32.90 | 70% | -- | 2026 |
| Michigan | $38.92 | 82.8% | -- | 2026 |
| Minnesota | $47.00 | 100% | -- | 2018 |
| Missouri | $42.30 | -- | Required | 2026 |
| Mississippi | $42.30 | 90% | -- | 2026 |
| Montana | $46.99 | 100% | -- | 2026 |
| North Dakota | $47.00 | 100% | Required | 2026 |
| Nebraska | $47.00 | 100% | -- | 2026 |
| New Jersey | $37.60 | 80% | Not required | 2026 |
| New Mexico | $47.00 | 100% | -- | 2024 |
| Ohio | $35.25 | 75% | -- | 2019 |
| Oklahoma | $41.81 | 89% | -- | 2026 |
| Oregon | $37.60* | 80% | -- | 2026 |
| Pennsylvania | $121.23 | 257.9% | -- | 2014 |
| Rhode Island | $50.20 | 106.8% | -- | 2026 |
| Texas | $64.39* | 137% | -- | 2021 |
| Virginia | $47.00 | 100% | -- | 2018 |
| Wisconsin | $47.00 | 100% | -- | 2018 |
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 81330?
30 state Medicaid programs publish a fee-for-service rate for 81330 (sMPD1 gene common variants (Niemann-Pick disease)), ranging from $28.20 in Hawaii to $158.09 in Kansas, with a median of 100% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for 81330?
Kansas publishes the highest Medicaid rate for 81330 at $158.09 (336.4% of the national Medicare amount). Hawaii publishes the lowest at $28.20.
Does 81330 require prior authorization under Medicaid?
4 of the 30 publishing states flag 81330 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".