The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 99091. 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
82.9%
Rate range
$32.87 - $183.01
99091 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $59.20 | 106.8% | -- | 2024 |
| California | $48.32 | 87.2% | -- | 2026 |
| Colorado | $42.57 | 76.8% | -- | 2026 |
| Connecticut | $42.33 | 76.4% | -- | 2026 |
| Idaho | $45.71 | 82.4% | Not required | 2026 |
| Indiana | $50.27 | 90.7% | Required | 2025 |
| Massachusetts | $39.78 | 71.8% | -- | 2026 |
| Mississippi | $47.30 | 85.3% | -- | 2026 |
| Montana | $72.57 | 130.9% | -- | 2026 |
| New Hampshire | $34.40 | 62% | Not required | 2026 |
| New Mexico | $77.81 | 140.3% | -- | 2025 |
| New York | $48.84 | 88.1% | -- | 2026 |
| Oregon | $44.55* | 80.4% | -- | 2026 |
| Texas | $183.01* | 330.1% | -- | 2021 |
| Virginia | $39.99* | 72.1% | -- | 2026 |
| Vermont | $45.97 | 82.9% | -- | 2026 |
| Washington | $32.87 | 59.3% | -- | 2026 |
| Wisconsin | $47.35 | 85.4% | -- | 2020 |
| West Virginia | $39.28 | 70.9% | -- | 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 99091?
19 state Medicaid programs publish a fee-for-service rate for 99091 (physiologic data collection and review, 30 days), ranging from $32.87 in Washington to $183.01 in Texas, with a median of 82.9% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for 99091?
Texas publishes the highest Medicaid rate for 99091 at $183.01 (330.1% of the national Medicare amount). Washington publishes the lowest at $32.87.
Does 99091 require prior authorization under Medicaid?
1 of the 19 publishing states flag 99091 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".