The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 98012. 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
19
Median % of Medicare
--
Rate range
$26.35 - $52.15
98012 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $26.99 | -- | -- | 2025 |
| Colorado | $48.25 | -- | -- | 2026 |
| Connecticut | $52.15 | -- | -- | 2026 |
| Delaware | $36.79 | -- | -- | 2026 |
| Idaho | $32.04 | -- | Not required | 2025 |
| Indiana | $34.00 | -- | -- | 2025 |
| Kentucky | $30.03 | -- | -- | 2026 |
| Minnesota | $29.12 | -- | -- | 2026 |
| Montana | $49.45 | -- | -- | 2026 |
| North Carolina | $28.82 | -- | -- | 2025 |
| North Dakota | $41.68 | -- | Not required | 2026 |
| Nebraska | $46.33 | -- | -- | 2026 |
| Ohio | $27.03 | -- | -- | 2025 |
| South Carolina | $43.30 | -- | -- | 2025 |
| Utah | $32.94* | -- | Not required | 2025 |
| Virginia | $27.22* | -- | -- | 2026 |
| Vermont | $49.53 | -- | -- | 2026 |
| Wisconsin | $26.82 | -- | -- | 2025 |
| West Virginia | $26.35 | -- | -- | 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 98012?
19 state Medicaid programs publish a fee-for-service rate for 98012 (audio-only visit, established patient, straightforward), ranging from $26.35 in West Virginia to $52.15 in Connecticut. The full table on this page lists every publishing state's current rate.
Which state pays the most for 98012?
Connecticut publishes the highest Medicaid rate for 98012 at $52.15. West Virginia publishes the lowest at $26.35.
Does 98012 require prior authorization under Medicaid?
No publishing state flags 98012 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.