The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 96170. 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
24
Median % of Medicare
--
Rate range
$6.92 - $81.30
96170 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $81.30 | -- | -- | 2025 |
| California | $70.29 | -- | -- | 2026 |
| Connecticut | $28.66 | -- | -- | 2026 |
| District of Columbia | $65.40 | -- | Not required | 2026 |
| Delaware | $73.04 | -- | -- | 2026 |
| Hawaii | $73.80 | -- | -- | 2025 |
| Iowa | $68.33 | -- | -- | 2025 |
| Indiana | $72.58 | -- | -- | 2025 |
| Kentucky | $64.42 | -- | -- | 2026 |
| Louisiana | $18.58 | -- | -- | 2026 |
| Massachusetts | $58.01 | -- | -- | 2026 |
| Maine | $52.16 | -- | -- | 2026 |
| Minnesota | $56.60 | -- | -- | 2026 |
| New Jersey | $6.92 | -- | Not required | 2026 |
| Nevada | $74.18 | -- | -- | 2024 |
| Ohio | $22.58 | -- | -- | 2026 |
| Oklahoma | $67.33 | -- | -- | 2026 |
| Texas | $65.12* | -- | -- | 2024 |
| Utah | $57.48* | -- | Not required | 2026 |
| Virginia | $64.81 | -- | -- | 2026 |
| Vermont | $62.23 | -- | -- | 2026 |
| Washington | $54.79 | -- | -- | 2026 |
| Wisconsin | $75.83 | -- | -- | 2022 |
| West Virginia | $52.46 | -- | -- | 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
- 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 96170?
24 state Medicaid programs publish a fee-for-service rate for 96170 (health behavior intervention, family only, first 30 min), ranging from $6.92 in New Jersey to $81.30 in Arizona. The full table on this page lists every publishing state's current rate.
Which state pays the most for 96170?
Arizona publishes the highest Medicaid rate for 96170 at $81.30. New Jersey publishes the lowest at $6.92.
Does 96170 require prior authorization under Medicaid?
No publishing state flags 96170 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.