The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 96567. Full schedules include every locality, modifier, and age-band variant.
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Publishing states
35
Median % of Medicare
81.6%
Rate range
$29.00 - $191.47
96567 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alaska | $191.47 | 148.1% | -- | 2026 |
| Alabama | $29.00 | 22.4% | -- | 2026 |
| Arkansas | $77.39 | 59.9% | -- | 2026 |
| Arizona | $134.24 | 103.9% | -- | 2025 |
| Colorado | $124.12 | 96% | -- | 2026 |
| Connecticut | $83.66 | 64.7% | -- | 2026 |
| Delaware | $125.13 | 96.8% | -- | 2026 |
| Hawaii | $157.00 | 121.5% | -- | 2025 |
| Idaho | $102.61 | 79.4% | Not required | 2026 |
| Indiana | $123.94 | 95.9% | -- | 2025 |
| Kentucky | $94.17 | 72.9% | -- | 2026 |
| Louisiana | $102.48 | 79.3% | -- | 2026 |
| Massachusetts | $112.69 | 87.2% | -- | 2026 |
| Maine | $86.03 | 66.6% | -- | 2026 |
| Minnesota | $102.14 | 79% | -- | 2026 |
| Missouri | $108.65 | 84.1% | Not required | 2022 |
| Mississippi | $100.13 | 77.5% | -- | 2026 |
| Montana | $179.37 | 138.8% | -- | 2026 |
| North Carolina | $90.29 | 69.9% | -- | 2025 |
| North Dakota | $144.94 | 112.1% | Required | 2026 |
| Nebraska | $81.70 | 63.2% | -- | 2026 |
| New Hampshire | $40.51 | 31.3% | Not required | 2026 |
| New Jersey | $67.67 | 52.4% | Not required | 2026 |
| New Mexico | $183.43 | 141.9% | -- | 2025 |
| Nevada | $124.48 | 96.3% | -- | 2024 |
| Ohio | $74.23 | 57.4% | -- | 2024 |
| Oklahoma | $107.81 | 83.4% | -- | 2026 |
| Oregon | $105.46* | 81.6% | -- | 2026 |
| Rhode Island | $80.38 | -- | -- | 2026 |
| South Carolina | $87.22 | 67.5% | -- | 2024 |
| Texas | $105.59* | 81.7% | -- | 2025 |
| Virginia | $111.98 | 86.6% | -- | 2026 |
| Wisconsin | $57.01 | 44.1% | -- | 2008 |
| West Virginia | $81.98 | 63.4% | -- | 2026 |
| Wyoming | $114.93 | 88.9% | -- | 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 96567?
35 state Medicaid programs publish a fee-for-service rate for 96567 (photodynamic therapy, external, skin lesions), ranging from $29.00 in Alabama to $191.47 in Alaska, with a median of 81.6% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for 96567?
Alaska publishes the highest Medicaid rate for 96567 at $191.47 (148.1% of the national Medicare amount). Alabama publishes the lowest at $29.00.
Does 96567 require prior authorization under Medicaid?
1 of the 35 publishing states flag 96567 as requiring prior authorization (always or conditionally) on their fee schedules. States without a flag publish no PA indicator for this code - that means "not published", not "no PA required".