The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 90621. 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
34
Median % of Medicare
--
Rate range
$8.07 - $241.27
90621 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $190.26 | -- | -- | 2026 |
| Arkansas | $131.81 | -- | -- | 2026 |
| Arizona | $225.91 | -- | -- | 2026 |
| California | $229.62 | -- | -- | 2026 |
| District of Columbia | $115.75 | -- | Not required | 2017 |
| Delaware | $15.00 | -- | -- | 2026 |
| Florida | $190.26* | -- | -- | 2025 |
| Iowa | $181.87 | -- | -- | 2024 |
| Idaho | $115.68 | -- | Not required | 2025 |
| Illinois | $16.26 | -- | -- | 2026 |
| Indiana | $236.42 | -- | -- | 2026 |
| Kansas | $207.32 | -- | -- | 2026 |
| Kentucky | $95.75 | -- | -- | 2026 |
| Maine | $122.70 | -- | -- | 2026 |
| Michigan | $238.67 | -- | -- | 2026 |
| Minnesota | $225.91 | -- | -- | 2026 |
| Missouri | $8.07* | -- | Not required | 2022 |
| Mississippi | $149.89 | -- | -- | 2020 |
| Montana | $207.32 | -- | -- | 2026 |
| North Carolina | $231.91 | -- | -- | 2026 |
| North Dakota | $225.91 | -- | Not required | 2026 |
| Nebraska | $241.27 | -- | -- | 2026 |
| New Hampshire | $225.16 | -- | Not required | 2026 |
| New Jersey | $222.91 | -- | Not required | 2026 |
| New Mexico | $149.39 | -- | -- | 2025 |
| Oklahoma | $210.82 | -- | -- | 2026 |
| Pennsylvania | $10.00 | -- | -- | 2024 |
| South Carolina | $222.17 | -- | -- | 2026 |
| Texas | $222.52* | -- | -- | 2025 |
| Utah | $207.32* | -- | Not required | 2025 |
| Virginia | $168.15 | -- | -- | 2022 |
| Washington | $139.52 | -- | -- | 2026 |
| Wisconsin | $207.32 | -- | -- | 2026 |
| Wyoming | $119.58 | -- | -- | 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 physician codes
- 10004 - Needle biopsy without imaging, each added lesion
- 10005 - Needle biopsy with ultrasound guidance, first lesion
- 10006 - Needle biopsy with ultrasound guidance, each added lesion
- 10007 - Needle biopsy with fluoroscopic guidance, first lesion
- 10009 - Needle biopsy with CT guidance, first lesion
- 10011 - Needle biopsy with MRI guidance, first lesion
- 10012 - Needle biopsy with MRI guidance, each added lesion
- 10021 - Fine needle aspiration biopsy, first lesion, no imaging
Frequently asked questions
How much does Medicaid pay for 90621?
34 state Medicaid programs publish a fee-for-service rate for 90621 (meningococcal B vaccine, FHbp (Trumenba)), ranging from $8.07 in Missouri to $241.27 in Nebraska. The full table on this page lists every publishing state's current rate.
Which state pays the most for 90621?
Nebraska publishes the highest Medicaid rate for 90621 at $241.27. Missouri publishes the lowest at $8.07.
Does 90621 require prior authorization under Medicaid?
No publishing state flags 90621 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.