The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 96549. 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
$29/mo after the trial. Cancel anytime.
Publishing states
12
Median % of Medicare
--
Rate range
$15.11 - $142.35
96549 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $29.00 | -- | -- | 2021 |
| District of Columbia | $18.00 | -- | Not required | 2018 |
| Hawaii | $41.60 | -- | -- | 2025 |
| Indiana | $134.36 | -- | -- | 2025 |
| Michigan | $25.02 | -- | -- | 2026 |
| Missouri | $42.21 | -- | Not required | 2026 |
| Mississippi | $35.56 | -- | -- | 2026 |
| Montana | $142.35 | -- | -- | 2026 |
| New Mexico | $25.67 | -- | -- | 2026 |
| Oklahoma | $42.17 | -- | -- | 2026 |
| Rhode Island | $36.58 | -- | -- | 2026 |
| Virginia | $15.11* | -- | -- | 2009 |
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 96549?
12 state Medicaid programs publish a fee-for-service rate for 96549 (unlisted chemotherapy procedure), ranging from $15.11 in Virginia to $142.35 in Montana. The full table on this page lists every publishing state's current rate.
Which state pays the most for 96549?
Montana publishes the highest Medicaid rate for 96549 at $142.35. Virginia publishes the lowest at $15.11.
Does 96549 require prior authorization under Medicaid?
No publishing state flags 96549 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.