The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 90750. 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
33
Median % of Medicare
--
Rate range
$10.00 - $280.00
90750 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $172.40 | -- | -- | 2026 |
| Arkansas | $112.00 | -- | -- | 2026 |
| Arizona | $234.69 | -- | -- | 2026 |
| California | $239.15 | -- | -- | 2026 |
| District of Columbia | $197.90 | -- | Not required | 2024 |
| Florida | $197.90 | -- | -- | 2025 |
| Iowa | $200.42 | -- | -- | 2024 |
| Illinois | $200.47 | -- | -- | 2025 |
| Indiana | $226.29 | -- | -- | 2026 |
| Kansas | $215.51 | -- | -- | 2026 |
| Kentucky | $280.00 | -- | -- | 2026 |
| Louisiana | $215.51 | -- | -- | 2026 |
| Maine | $148.95 | -- | -- | 2026 |
| Michigan | $248.77 | -- | -- | 2026 |
| Minnesota | $242.67 | -- | -- | 2026 |
| Mississippi | $151.41 | -- | -- | 2020 |
| Montana | $171.57 | -- | -- | 2026 |
| North Carolina | $249.95 | -- | -- | 2026 |
| North Dakota | $234.69 | -- | Not required | 2026 |
| Nebraska | $250.65 | -- | -- | 2026 |
| New Hampshire | $215.51 | -- | Not required | 2026 |
| New Jersey | $228.65 | -- | Not required | 2026 |
| New Mexico | $187.33 | -- | -- | 2025 |
| Oklahoma | $219.74 | -- | -- | 2026 |
| Pennsylvania | $10.00 | -- | -- | 2024 |
| South Carolina | $230.94 | -- | -- | 2026 |
| Texas | $231.46* | -- | -- | 2025 |
| Utah | $207.55* | -- | Not required | 2025 |
| Virginia | $171.57* | -- | -- | 2022 |
| Vermont | $155.48 | -- | -- | 2026 |
| Washington | $234.69 | -- | -- | 2026 |
| Wisconsin | $215.51 | -- | -- | 2026 |
| Wyoming | $136.50* | -- | -- | 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
- 10021 - Fine needle aspiration biopsy, first lesion, no imaging
- 10060 - Drainage of a skin abscess, simple
- 10061 - Drainage of a skin abscess, complicated or multiple
- 10120 - Removal of a foreign body from tissue, simple
- 10140 - Drainage of a blood or fluid collection under the skin
- 11042 - Wound debridement, skin and tissue below, first 20 sq cm
- 11043 - Wound debridement to muscle, first 20 sq cm
- 11044 - Wound debridement to bone, first 20 sq cm
Frequently asked questions
How much does Medicaid pay for 90750?
33 state Medicaid programs publish a fee-for-service rate for 90750 (shingles vaccine, recombinant (add-on schedule)), ranging from $10.00 in Pennsylvania to $280.00 in Kentucky. The full table on this page lists every publishing state's current rate.
Which state pays the most for 90750?
Kentucky publishes the highest Medicaid rate for 90750 at $280.00. Pennsylvania publishes the lowest at $10.00.
Does 90750 require prior authorization under Medicaid?
No publishing state flags 90750 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.