The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 98975. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
- Full-schedule CSV export
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Publishing states
25
Median % of Medicare
77.2%
Rate range
$11.26 - $146.36
98975 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $20.57 | 94.7% | -- | 2025 |
| Colorado | $17.51 | 80.7% | -- | 2026 |
| Delaware | $20.96 | 96.5% | -- | 2026 |
| Georgia | $15.84 | 73% | -- | 2026 |
| Hawaii | $22.56 | 103.9% | -- | 2025 |
| Iowa | $16.54 | 76.2% | -- | 2026 |
| Indiana | $17.91 | 82.5% | Required | 2026 |
| Kentucky | $14.41 | 66.4% | -- | 2026 |
| Massachusetts | $15.13 | 69.7% | -- | 2026 |
| Maine | $14.31 | 65.9% | -- | 2026 |
| Michigan | $71.14 | -- | -- | 2026 |
| Minnesota | $16.72 | 77% | -- | 2026 |
| Mississippi | $16.75 | 77.2% | -- | 2026 |
| Montana | $27.70 | 127.6% | -- | 2026 |
| North Carolina | $15.40 | 70.9% | -- | 2025 |
| Nebraska | $42.76 | 197% | -- | 2026 |
| New Hampshire | $19.03 | 87.7% | Not required | 2026 |
| New Jersey | $11.26 | 51.9% | Not required | 2026 |
| New Mexico | $27.02 | 124.5% | -- | 2025 |
| Ohio | $13.84 | 63.7% | -- | 2022 |
| Oregon | $17.56* | 80.9% | -- | 2026 |
| Pennsylvania | $15.96 | 73.5% | -- | 2026 |
| Rhode Island | $146.36 | -- | -- | 2026 |
| Virginia | $18.81 | 86.6% | -- | 2026 |
| West Virginia | $14.15 | 65.2% | -- | 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 98975?
25 state Medicaid programs publish a fee-for-service rate for 98975 (remote therapeutic monitoring, initial set-up and education), ranging from $11.26 in New Jersey to $146.36 in Rhode Island, with a median of 77.2% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for 98975?
Rhode Island publishes the highest Medicaid rate for 98975 at $146.36. New Jersey publishes the lowest at $11.26.
Does 98975 require prior authorization under Medicaid?
1 of the 25 publishing states flag 98975 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".