The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 90747. 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
$29/mo after the trial. Cancel anytime.
Publishing states
35
Median % of Medicare
--
Rate range
$4.00 - $170.94
90747 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $140.75 | -- | -- | 2026 |
| Arkansas | $110.20 | -- | -- | 2026 |
| Arizona | $170.94 | -- | -- | 2026 |
| California | $168.88 | -- | -- | 2026 |
| Connecticut | $164.42 | -- | -- | 2026 |
| District of Columbia | $164.42 | -- | Not required | 2026 |
| Delaware | $15.00 | -- | -- | 2026 |
| Hawaii | $4.00 | -- | -- | 2025 |
| Iowa | $135.15 | -- | -- | 2024 |
| Idaho | $142.06 | -- | Not required | 2026 |
| Illinois | $16.26 | -- | -- | 2026 |
| Indiana | $156.14 | -- | -- | 2026 |
| Kansas | $170.94 | -- | -- | 2026 |
| Kentucky | $119.42 | -- | -- | 2026 |
| Maine | $170.94 | -- | -- | 2026 |
| Michigan | $170.94 | -- | -- | 2026 |
| Minnesota | $170.94 | -- | -- | 2026 |
| Mississippi | $140.75 | -- | -- | 2023 |
| Montana | $164.42 | -- | -- | 2026 |
| North Carolina | $153.16 | -- | -- | 2026 |
| North Dakota | $170.94 | -- | Not required | 2026 |
| Nebraska | $170.94 | -- | -- | 2026 |
| New Hampshire | $74.35 | -- | Not required | 2026 |
| New Jersey | $113.53 | -- | Not required | 2026 |
| New Mexico | $140.75 | -- | -- | 2025 |
| Oklahoma | $153.95 | -- | -- | 2026 |
| Pennsylvania | $10.00 | -- | -- | 2024 |
| South Carolina | $147.55 | -- | -- | 2026 |
| Texas | $132.60* | -- | -- | 2024 |
| Utah | $170.94* | -- | Not required | 2026 |
| Virginia | $122.95* | -- | -- | 2016 |
| Vermont | $133.71 | -- | -- | 2026 |
| Washington | $170.94 | -- | -- | 2026 |
| Wisconsin | $104.75 | -- | -- | 2026 |
| Wyoming | $140.75 | -- | -- | 2023 |
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 90747?
35 state Medicaid programs publish a fee-for-service rate for 90747 (hepatitis B vaccine, dialysis or immunosuppressed, 4-dose), ranging from $4.00 in Hawaii to $170.94 in Arizona. The full table on this page lists every publishing state's current rate.
Which state pays the most for 90747?
Arizona publishes the highest Medicaid rate for 90747 at $170.94. Hawaii publishes the lowest at $4.00.
Does 90747 require prior authorization under Medicaid?
No publishing state flags 90747 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.