The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 90657. 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
30
Median % of Medicare
--
Rate range
$4.00 - $19.48
90657 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arkansas | $15.45* | -- | -- | 2026 |
| Arizona | $11.14 | -- | -- | 2026 |
| California | $15.49 | -- | -- | 2026 |
| Connecticut | $11.03 | -- | -- | 2026 |
| District of Columbia | $11.03 | -- | Not required | 2025 |
| Delaware | $15.00 | -- | -- | 2026 |
| Hawaii | $4.00 | -- | -- | 2025 |
| Iowa | $9.71 | -- | -- | 2024 |
| Idaho | $9.53 | -- | Not required | 2026 |
| Illinois | $16.26 | -- | -- | 2025 |
| Indiana | $9.83 | -- | -- | 2025 |
| Kansas | $11.03 | -- | -- | 2025 |
| Kentucky | $18.40 | -- | -- | 2026 |
| Maine | $11.14 | -- | -- | 2026 |
| Minnesota | $11.14 | -- | -- | 2026 |
| Missouri | $8.07* | -- | Not required | 2024 |
| Mississippi | $6.02 | -- | -- | 2014 |
| North Dakota | $11.03 | -- | Not required | 2026 |
| Nebraska | $10.92* | -- | -- | 2026 |
| New Hampshire | $9.99 | -- | Not required | 2026 |
| New Jersey | $9.58 | -- | Not required | 2026 |
| New Mexico | $10.93 | -- | -- | 2025 |
| Oklahoma | $10.33 | -- | -- | 2026 |
| Pennsylvania | $10.00 | -- | -- | 2024 |
| South Carolina | $9.52 | -- | -- | 2025 |
| Utah | $11.03* | -- | Not required | 2025 |
| Virginia | $11.03* | -- | -- | 2025 |
| Vermont | $10.48 | -- | -- | 2026 |
| Washington | $11.03 | -- | -- | 2026 |
| Wisconsin | $19.48 | -- | -- | 2025 |
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 90657?
30 state Medicaid programs publish a fee-for-service rate for 90657 (flu vaccine, trivalent, 6-35 months), ranging from $4.00 in Hawaii to $19.48 in Wisconsin. The full table on this page lists every publishing state's current rate.
Which state pays the most for 90657?
Wisconsin publishes the highest Medicaid rate for 90657 at $19.48. Hawaii publishes the lowest at $4.00.
Does 90657 require prior authorization under Medicaid?
No publishing state flags 90657 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.