The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 94772. 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
35
Median % of Medicare
--
Rate range
$10.08 - $480.17
94772 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alaska | $431.00 | -- | -- | 2026 |
| Alabama | $67.50 | -- | -- | 2026 |
| Arkansas | $94.60 | -- | -- | 2026 |
| Arizona | $353.64 | -- | -- | 2021 |
| California | $43.80 | -- | -- | 2026 |
| Colorado | $137.04 | -- | -- | 2026 |
| Connecticut | $50.23 | -- | -- | 2026 |
| District of Columbia | $134.00 | -- | Not required | 2000 |
| Delaware | $167.00 | -- | -- | 2026 |
| Georgia | $37.62 | -- | -- | 2026 |
| Iowa | $107.30 | -- | -- | 2024 |
| Idaho | $196.89 | -- | Not required | 2025 |
| Indiana | $480.17 | -- | -- | 2025 |
| Kansas | $82.00 | -- | -- | 1978 |
| Kentucky | $207.47 | -- | -- | 2026 |
| Louisiana | $161.82 | -- | -- | 2026 |
| Maine | $45.45 | -- | -- | 2026 |
| Michigan | $282.86 | -- | -- | 2026 |
| Minnesota | $250.86 | -- | -- | 2025 |
| Missouri | $171.34 | -- | Not required | 2019 |
| Mississippi | $283.38 | -- | -- | 2026 |
| North Carolina | $92.78 | -- | -- | 2025 |
| Nebraska | $164.52 | -- | -- | 2026 |
| New Hampshire | $78.83 | -- | Not required | 2026 |
| New Jersey | $234.49 | -- | Not required | 2026 |
| New Mexico | $119.90 | -- | -- | 2025 |
| New York | $42.42 | -- | -- | 2026 |
| Ohio | $40.70 | -- | -- | 2000 |
| Rhode Island | $271.38 | -- | -- | 2026 |
| South Carolina | $199.04 | -- | -- | 2017 |
| Texas | $102.17 | -- | -- | 2025 |
| Utah | $87.82* | -- | Not required | 2024 |
| Virginia | $10.08* | -- | -- | 2009 |
| Washington | $180.53 | -- | -- | 2026 |
| Wisconsin | $126.57 | -- | -- | 2008 |
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 94772?
35 state Medicaid programs publish a fee-for-service rate for 94772 (infant breathing pattern recording (pneumogram)), ranging from $10.08 in Virginia to $480.17 in Indiana. The full table on this page lists every publishing state's current rate.
Which state pays the most for 94772?
Indiana publishes the highest Medicaid rate for 94772 at $480.17. Virginia publishes the lowest at $10.08.
Does 94772 require prior authorization under Medicaid?
No publishing state flags 94772 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.