The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 85366. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
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Publishing states
44
Median % of Medicare
85%
Rate range
$2.63 - $110.23
85366 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alaska | $80.46 | 100% | -- | 2026 |
| Alabama | $56.32 | -- | -- | 2026 |
| Arkansas | $12.30 | 15.3% | -- | 2026 |
| Arizona | $80.46 | 100% | -- | 2026 |
| California | $8.57 | 10.7% | -- | 2026 |
| Connecticut | $8.22 | 10.2% | -- | 2015 |
| District of Columbia | $64.37 | 80% | Not required | 2018 |
| Delaware | $78.85 | 98% | -- | 2026 |
| Georgia | $10.83 | 13.5% | -- | 2026 |
| Hawaii | $7.22 | 9% | -- | 2025 |
| Iowa | $7.57 | 9.4% | -- | 2024 |
| Idaho | $69.51 | 86.4% | Not required | 2025 |
| Illinois | $54.80 | 68.1% | -- | 2024 |
| Indiana | $80.46 | 100% | -- | 2024 |
| Kansas | $10.20 | 12.7% | -- | 1993 |
| Kentucky | $80.46 | 100% | -- | 2026 |
| Louisiana | $68.39 | 85% | -- | 2026 |
| Massachusetts | $70.96 | 88.2% | -- | 2024 |
| Maine | $7.71 | 9.6% | -- | 2026 |
| Michigan | $66.62 | 82.8% | -- | 2026 |
| Minnesota | $80.46 | 100% | -- | 2018 |
| Missouri | $72.41 | -- | Not required | 2026 |
| Mississippi | $72.41 | 90% | -- | 2026 |
| Montana | $80.46 | 100% | -- | 2026 |
| North Dakota | $80.46 | 100% | Not required | 2026 |
| Nebraska | $80.46 | 100% | -- | 2026 |
| New Hampshire | $69.60 | 86.5% | Not required | 2026 |
| New Jersey | $64.37 | 80% | Not required | 2026 |
| New Mexico | $80.46 | 100% | -- | 2023 |
| Nevada | $6.01 | 7.5% | -- | 2024 |
| Ohio | $60.35 | 75% | -- | 2019 |
| Oklahoma | $71.57 | 89% | -- | 2026 |
| Oregon | $64.37* | 80% | -- | 2026 |
| Pennsylvania | $11.79 | -- | -- | 2009 |
| Rhode Island | $17.08 | -- | -- | 2026 |
| South Carolina | $5.38 | -- | -- | 2026 |
| Texas | $110.23* | 137% | -- | 2021 |
| Utah | $80.22* | 99.7% | Not required | 2026 |
| Virginia | $2.63 | 3.3% | -- | 2014 |
| Vermont | $78.45 | 97.5% | -- | 2026 |
| Washington | $64.37 | 80% | -- | 2026 |
| Wisconsin | $11.72 | 14.6% | -- | 2015 |
| West Virginia | $72.41 | 90% | -- | 2026 |
| Wyoming | $10.56 | 13.1% | -- | 2021 |
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 85366?
44 state Medicaid programs publish a fee-for-service rate for 85366 (fibrin degradation products, paracoagulation), ranging from $2.63 in Virginia to $110.23 in Texas, with a median of 85% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for 85366?
Texas publishes the highest Medicaid rate for 85366 at $110.23 (137% of the national Medicare amount). Virginia publishes the lowest at $2.63.
Does 85366 require prior authorization under Medicaid?
No publishing state flags 85366 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.