The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 94642. 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
39
Median % of Medicare
--
Rate range
$5.50 - $183.43
94642 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $139.00 | -- | -- | 2026 |
| Arkansas | $5.60 | -- | -- | 2026 |
| Arizona | $35.50 | -- | -- | 2020 |
| California | $85.90 | -- | -- | 2026 |
| Colorado | $146.26 | -- | -- | 2026 |
| Connecticut | $38.86 | -- | -- | 2008 |
| District of Columbia | $16.00 | -- | Not required | 2016 |
| Delaware | $34.88 | -- | -- | 2026 |
| Georgia | $28.22 | -- | -- | 2026 |
| Hawaii | $5.50 | -- | -- | 2025 |
| Iowa | $58.64 | -- | -- | 2024 |
| Idaho | $35.88 | -- | Not required | 2025 |
| Illinois | $21.45 | -- | -- | 2026 |
| Indiana | $41.00 | -- | -- | 2024 |
| Kansas | $12.88 | -- | -- | 2011 |
| Kentucky | $43.41 | -- | -- | 2026 |
| Louisiana | $6.03 | -- | -- | 2026 |
| Maine | $32.30 | -- | -- | 2026 |
| Michigan | $18.04 | -- | -- | 2026 |
| Minnesota | $34.22 | -- | -- | 2026 |
| Mississippi | $183.43 | -- | -- | 2026 |
| Montana | $12.73 | -- | -- | 2026 |
| North Carolina | $8.92 | -- | -- | 2025 |
| Nebraska | $54.84 | -- | -- | 2026 |
| New Jersey | $30.00 | -- | Not required | 2026 |
| New Mexico | $35.02 | -- | -- | 2025 |
| Nevada | $68.17 | -- | -- | 2024 |
| New York | $37.53 | -- | -- | 2026 |
| Oklahoma | $18.16 | -- | -- | 2026 |
| Pennsylvania | $31.20 | -- | -- | 2012 |
| Rhode Island | $134.97 | -- | -- | 2026 |
| South Carolina | $20.37 | -- | -- | 2017 |
| Texas | $15.30* | -- | -- | 2024 |
| Utah | $58.82* | -- | Not required | 2021 |
| Virginia | $18.48* | -- | -- | 2016 |
| Washington | $34.79 | -- | -- | 2026 |
| Wisconsin | $122.32 | -- | -- | 2008 |
| West Virginia | $6.02 | -- | -- | 2026 |
| Wyoming | $20.74 | -- | -- | 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
- 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 94642?
39 state Medicaid programs publish a fee-for-service rate for 94642 (inhaled pentamidine treatment), ranging from $5.50 in Hawaii to $183.43 in Mississippi. The full table on this page lists every publishing state's current rate.
Which state pays the most for 94642?
Mississippi publishes the highest Medicaid rate for 94642 at $183.43. Hawaii publishes the lowest at $5.50.
Does 94642 require prior authorization under Medicaid?
No publishing state flags 94642 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.