The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 90961. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
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Publishing states
43
Median % of Medicare
75.7%
Rate range
$149.25 - $563.77
90961 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alaska | $563.77 | 181.5% | -- | 2026 |
| Alabama | $216.00 | 69.5% | -- | 2026 |
| Arizona | $308.25 | 99.2% | -- | 2022 |
| California | $193.20 | 62.2% | -- | 2026 |
| Colorado | $246.07 | 79.2% | -- | 2026 |
| Connecticut | $236.58 | 76.2% | -- | 2009 |
| District of Columbia | $273.82 | 88.2% | Not required | 2026 |
| Delaware | $302.79 | 97.5% | -- | 2026 |
| Hawaii | $299.48 | 96.4% | -- | 2025 |
| Iowa | $179.47 | 57.8% | -- | 2024 |
| Idaho | $255.01 | 82.1% | Not required | 2026 |
| Illinois | $207.88 | 66.9% | -- | 2009 |
| Indiana | $272.49 | 87.7% | -- | 2025 |
| Kansas | $176.55 | 56.8% | -- | 2024 |
| Kentucky | $181.88 | 58.6% | -- | 2026 |
| Louisiana | $236.92 | 76.3% | -- | 2026 |
| Massachusetts | $216.95 | 69.8% | -- | 2026 |
| Maine | $214.98 | 69.2% | -- | 2026 |
| Michigan | $198.09 | 63.8% | -- | 2026 |
| Minnesota | $235.17 | 75.7% | -- | 2026 |
| Missouri | $222.05 | 71.5% | Not required | 2022 |
| Mississippi | $262.45 | 84.5% | -- | 2026 |
| Montana | $399.29 | 128.5% | -- | 2026 |
| North Carolina | $184.68 | 59.5% | -- | 2025 |
| North Dakota | $341.32 | 109.9% | Not required | 2026 |
| Nebraska | $191.94 | 61.8% | -- | 2026 |
| New Hampshire | $149.25 | 48% | Not required | 2026 |
| New Jersey | $219.29 | 70.6% | Not required | 2026 |
| New Mexico | $418.24 | 134.6% | -- | 2025 |
| Nevada | $220.40 | 71% | -- | 2024 |
| New York | $258.10 | 83.1% | -- | 2026 |
| Ohio | $160.44 | 51.7% | -- | 2024 |
| Oklahoma | $277.08 | 89.2% | -- | 2026 |
| Oregon | $249.96* | 80.5% | -- | 2026 |
| South Carolina | $195.51 | 62.9% | -- | 2024 |
| Texas | $235.23* | 75.7% | -- | 2025 |
| Utah | $237.50* | 76.5% | Not required | 2026 |
| Virginia | $269.10* | 86.6% | -- | 2026 |
| Vermont | $258.02 | 83.1% | -- | 2026 |
| Washington | $185.56 | 59.7% | -- | 2026 |
| Wisconsin | $225.63 | 72.6% | -- | 2009 |
| West Virginia | $217.16 | 69.9% | -- | 2026 |
| Wyoming | $253.63* | 81.7% | -- | 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 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 90961?
43 state Medicaid programs publish a fee-for-service rate for 90961 (monthly dialysis management, age 20+, 2-3 visits), ranging from $149.25 in New Hampshire to $563.77 in Alaska, with a median of 75.7% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for 90961?
Alaska publishes the highest Medicaid rate for 90961 at $563.77 (181.5% of the national Medicare amount). New Hampshire publishes the lowest at $149.25.
Does 90961 require prior authorization under Medicaid?
No publishing state flags 90961 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.