The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 98004. 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
17
Median % of Medicare
--
Rate range
$28.79 - $53.99
98004 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $42.12 | -- | -- | 2025 |
| Colorado | $48.25 | -- | -- | 2026 |
| Connecticut | $53.15 | -- | -- | 2026 |
| Delaware | $40.05 | -- | -- | 2026 |
| Idaho | $35.00 | -- | Not required | 2025 |
| Indiana | $37.14 | -- | -- | 2025 |
| Kentucky | $32.75 | -- | -- | 2026 |
| Minnesota | $46.18 | -- | -- | 2026 |
| Montana | $53.99 | -- | -- | 2026 |
| North Carolina | $31.47 | -- | -- | 2025 |
| North Dakota | $45.43 | -- | Not required | 2026 |
| Nebraska | $32.90 | -- | -- | 2026 |
| Ohio | $29.48 | -- | -- | 2025 |
| Virginia | $29.63* | -- | -- | 2026 |
| Vermont | $49.53 | -- | -- | 2026 |
| Wisconsin | $29.33 | -- | -- | 2025 |
| West Virginia | $28.79 | -- | -- | 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 98004?
17 state Medicaid programs publish a fee-for-service rate for 98004 (video visit, established patient, straightforward), ranging from $28.79 in West Virginia to $53.99 in Montana. The full table on this page lists every publishing state's current rate.
Which state pays the most for 98004?
Montana publishes the highest Medicaid rate for 98004 at $53.99. West Virginia publishes the lowest at $28.79.
Does 98004 require prior authorization under Medicaid?
No publishing state flags 98004 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.