The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 98961. 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
18
Median % of Medicare
--
Rate range
$4.60 - $20.22
98961 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $12.59 | -- | -- | 2025 |
| California | $13.29 | -- | -- | 2026 |
| Delaware | $15.17 | -- | -- | 2026 |
| Iowa | $20.22 | -- | -- | 2024 |
| Idaho | $10.68 | -- | Not required | 2025 |
| Indiana | $13.28 | -- | -- | 2026 |
| Kansas | $4.60 | -- | -- | 2023 |
| Kentucky | $10.88 | -- | -- | 2026 |
| Louisiana | $6.04 | -- | -- | 2026 |
| Massachusetts | $11.18 | -- | -- | 2026 |
| Michigan | $5.23 | -- | -- | 2026 |
| Minnesota | $12.09 | -- | -- | 2026 |
| North Dakota | $17.27 | -- | Not required | 2026 |
| New Jersey | $6.85 | -- | Not required | 2026 |
| Nevada | $11.86 | -- | -- | 2025 |
| New York | $16.45 | -- | -- | 2026 |
| Utah | $11.57* | -- | Not required | 2026 |
| West Virginia | $10.00 | -- | -- | 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 98961?
18 state Medicaid programs publish a fee-for-service rate for 98961 (self-management education, group of 2-4, 30 minutes), ranging from $4.60 in Kansas to $20.22 in Iowa. The full table on this page lists every publishing state's current rate.
Which state pays the most for 98961?
Iowa publishes the highest Medicaid rate for 98961 at $20.22. Kansas publishes the lowest at $4.60.
Does 98961 require prior authorization under Medicaid?
No publishing state flags 98961 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.