The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 98960. 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
22
Median % of Medicare
--
Rate range
$3.75 - $101.50
98960 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $26.03 | -- | -- | 2025 |
| California | $27.54 | -- | -- | 2026 |
| Colorado | $3.75* | -- | -- | 2026 |
| Delaware | $32.28 | -- | -- | 2026 |
| Hawaii | $34.80 | -- | -- | 2025 |
| Iowa | $20.22 | -- | -- | 2024 |
| Idaho | $22.18 | -- | Not required | 2025 |
| Indiana | $27.75 | -- | -- | 2026 |
| Kansas | $9.70 | -- | -- | 2023 |
| Kentucky | $22.53 | -- | -- | 2026 |
| Louisiana | $18.11 | -- | -- | 2026 |
| Massachusetts | $23.17 | -- | -- | 2026 |
| Michigan | $10.26 | -- | -- | 2026 |
| Minnesota | $25.98 | -- | -- | 2026 |
| Missouri | $101.50 | -- | Required | 2019 |
| North Dakota | $37.17 | -- | Not required | 2026 |
| New Jersey | $13.88 | -- | Not required | 2026 |
| Nevada | $24.66 | -- | -- | 2025 |
| New York | $35.00 | -- | -- | 2026 |
| Texas | $26.38* | -- | -- | 2025 |
| Utah | $24.62* | -- | Not required | 2026 |
| West Virginia | $21.47 | -- | -- | 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 98960?
22 state Medicaid programs publish a fee-for-service rate for 98960 (self-management education, individual, 30 minutes), ranging from $3.75 in Colorado to $101.50 in Missouri. The full table on this page lists every publishing state's current rate.
Which state pays the most for 98960?
Missouri publishes the highest Medicaid rate for 98960 at $101.50. Colorado publishes the lowest at $3.75.
Does 98960 require prior authorization under Medicaid?
1 of the 22 publishing states flag 98960 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".