The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 98011. 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
13
Median % of Medicare
--
Rate range
$119.32 - $222.33
98011 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $122.08 | -- | -- | 2025 |
| Colorado | $189.00 | -- | -- | 2026 |
| Delaware | $165.48 | -- | -- | 2026 |
| Idaho | $144.81 | -- | Not required | 2025 |
| Kentucky | $135.67 | -- | -- | 2026 |
| Minnesota | $130.67 | -- | -- | 2026 |
| Montana | $222.33 | -- | -- | 2026 |
| North Carolina | $129.99 | -- | -- | 2025 |
| North Dakota | $186.24 | -- | Not required | 2026 |
| Virginia | $122.39* | -- | -- | 2026 |
| Vermont | $195.56 | -- | -- | 2026 |
| Wisconsin | $120.75 | -- | -- | 2025 |
| West Virginia | $119.32 | -- | -- | 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 98011?
13 state Medicaid programs publish a fee-for-service rate for 98011 (audio-only visit, new patient, high complexity), ranging from $119.32 in West Virginia to $222.33 in Montana. The full table on this page lists every publishing state's current rate.
Which state pays the most for 98011?
Montana publishes the highest Medicaid rate for 98011 at $222.33. West Virginia publishes the lowest at $119.32.
Does 98011 require prior authorization under Medicaid?
No publishing state flags 98011 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.