The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 86985. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
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- Email alerts when a state changes its rates
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Publishing states
24
Median % of Medicare
--
Rate range
$5.63 - $999.99
86985 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $9.00 | -- | -- | 2026 |
| Arkansas | $7.00 | -- | -- | 2026 |
| Arizona | $12.78 | -- | -- | 2026 |
| Colorado | $6.27 | -- | -- | 2026 |
| Connecticut | $15.96 | -- | -- | 2015 |
| Delaware | $101.80 | -- | -- | 2026 |
| Hawaii | $9.00 | -- | -- | 2025 |
| Iowa | $24.16 | -- | -- | 2024 |
| Illinois | $7.98 | -- | -- | 2013 |
| Indiana | $19.52 | -- | -- | 2026 |
| Louisiana | $10.97 | -- | -- | 2026 |
| Maine | $999.99 | -- | -- | 2026 |
| Michigan | $91.03 | -- | -- | 2026 |
| Missouri | $153.58 | -- | Not required | 2026 |
| Mississippi | $10.91 | -- | -- | 2026 |
| New Hampshire | $5.63 | -- | Not required | 2026 |
| New Jersey | $25.00 | -- | Not required | 2026 |
| New Mexico | $28.98 | -- | -- | 2025 |
| Nevada | $13.83 | -- | -- | 2024 |
| Ohio | $13.50 | -- | -- | 2018 |
| Oklahoma | $18.72 | -- | -- | 2026 |
| South Carolina | $52.86 | -- | -- | 2026 |
| Wisconsin | $20.63 | -- | -- | 2008 |
| West Virginia | $22.13 | -- | -- | 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 86985?
24 state Medicaid programs publish a fee-for-service rate for 86985 (blood product splitting, each unit), ranging from $5.63 in New Hampshire to $999.99 in Maine. The full table on this page lists every publishing state's current rate.
Which state pays the most for 86985?
Maine publishes the highest Medicaid rate for 86985 at $999.99. New Hampshire publishes the lowest at $5.63.
Does 86985 require prior authorization under Medicaid?
No publishing state flags 86985 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.