The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 90869. 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
28
Median % of Medicare
--
Rate range
$69.49 - $576.60
90869 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $208.90 | -- | -- | 2021 |
| California | $123.15 | -- | -- | 2026 |
| Connecticut | $191.59 | -- | -- | 2026 |
| Delaware | $113.18 | -- | -- | 2026 |
| Hawaii | $69.49 | -- | -- | 2025 |
| Iowa | $131.77 | -- | -- | 2025 |
| Illinois | $217.48 | -- | -- | 2025 |
| Indiana | $144.52 | -- | Required | 2024 |
| Kentucky | $434.21 | -- | -- | 2026 |
| Maryland | $576.60 | -- | -- | 2026 |
| Maine | $231.19 | -- | -- | 2026 |
| Michigan | $98.45 | -- | -- | 2026 |
| Minnesota | $186.28 | -- | Required | 2026 |
| Missouri | $111.08 | -- | Not required | 2022 |
| New Hampshire | $207.13 | -- | Required | 2026 |
| New Jersey | $100.04 | -- | Not required | 2026 |
| New Mexico | $532.17 | -- | -- | 2025 |
| Nevada | $461.34 | -- | -- | 2024 |
| New York | $255.36 | -- | -- | 2026 |
| Ohio | $141.47 | -- | -- | 2022 |
| Pennsylvania | $168.89 | -- | -- | 2024 |
| Rhode Island | $116.75 | -- | -- | 2026 |
| South Carolina | $181.29 | -- | -- | 2017 |
| Utah | $324.29* | -- | Required | 2026 |
| Virginia | $544.08 | -- | -- | 2026 |
| Washington | $186.50 | -- | -- | 2026 |
| West Virginia | $172.80 | -- | -- | 2026 |
| Wyoming | $400.01 | -- | -- | 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 behavioral health codes
- 90785 - Psychotherapy interactive complexity (add-on)
- 90791 - Psychiatric diagnostic evaluation, no medical services
- 90792 - Psychiatric diagnostic evaluation with medical services
- 90832 - Psychotherapy, 30 minutes
- 90833 - Psychotherapy, 30 minutes, added to an E&M visit
- 90834 - Psychotherapy, 45 minutes
- 90836 - Psychotherapy, 45 minutes, added to an E&M visit
- 90837 - Psychotherapy, 60 minutes
Frequently asked questions
How much does Medicaid pay for 90869?
28 state Medicaid programs publish a fee-for-service rate for 90869 (tMS treatment, later session with motor threshold re-check), ranging from $69.49 in Hawaii to $576.60 in Maryland. The full table on this page lists every publishing state's current rate.
Which state pays the most for 90869?
Maryland publishes the highest Medicaid rate for 90869 at $576.60. Hawaii publishes the lowest at $69.49.
Does 90869 require prior authorization under Medicaid?
4 of the 28 publishing states flag 90869 as requiring prior authorization (always or conditionally) on their fee schedules. States without a flag publish no PA indicator for this code - that means "not published", not "no PA required".