The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 99252. 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
31
Median % of Medicare
--
Rate range
$30.24 - $132.46
99252 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alaska | $132.46 | -- | -- | 2026 |
| Alabama | $60.00 | -- | -- | 2026 |
| Arkansas | $72.60 | -- | -- | 2026 |
| Arizona | $66.15 | -- | -- | 2022 |
| California | $32.46 | -- | -- | 2026 |
| Connecticut | $45.41 | -- | -- | 2012 |
| District of Columbia | $60.99 | -- | Not required | 2026 |
| Florida | $72.81 | -- | -- | 2025 |
| Georgia | $65.63 | -- | -- | 2026 |
| Illinois | $33.03 | -- | -- | 2026 |
| Kentucky | $55.73 | -- | -- | 2026 |
| Massachusetts | $52.65 | -- | -- | 2026 |
| Michigan | $44.73 | -- | -- | 2026 |
| Minnesota | $53.79 | -- | -- | 2026 |
| Mississippi | $67.03 | -- | -- | 2026 |
| North Carolina | $61.35 | -- | -- | 2025 |
| Nebraska | $98.71 | -- | -- | 2026 |
| New Jersey | $93.36 | -- | Not required | 2026 |
| New Mexico | $102.05 | -- | -- | 2025 |
| Nevada | $77.61 | -- | -- | 2024 |
| New York | $30.24 | -- | -- | 2026 |
| Ohio | $39.18 | -- | -- | 2024 |
| Pennsylvania | $56.27 | -- | -- | 2023 |
| South Carolina | $52.32 | -- | -- | 2024 |
| Texas | $64.93* | -- | -- | 2021 |
| Utah | $54.03* | -- | Not required | 2026 |
| Virginia | $50.59* | -- | -- | 2026 |
| Washington | $41.47 | -- | -- | 2026 |
| Wisconsin | $61.99 | -- | -- | 2020 |
| West Virginia | $49.53 | -- | -- | 2026 |
| Wyoming | $75.83 | -- | -- | 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
- 10021 - Fine needle aspiration biopsy, first lesion, no imaging
- 10060 - Drainage of a skin abscess, simple
- 10061 - Drainage of a skin abscess, complicated or multiple
- 10120 - Removal of a foreign body from tissue, simple
- 10140 - Drainage of a blood or fluid collection under the skin
- 11042 - Wound debridement, skin and tissue below, first 20 sq cm
- 11043 - Wound debridement to muscle, first 20 sq cm
- 11044 - Wound debridement to bone, first 20 sq cm
Frequently asked questions
How much does Medicaid pay for 99252?
31 state Medicaid programs publish a fee-for-service rate for 99252 (inpatient consultation, straightforward), ranging from $30.24 in New York to $132.46 in Alaska. The full table on this page lists every publishing state's current rate.
Which state pays the most for 99252?
Alaska publishes the highest Medicaid rate for 99252 at $132.46. New York publishes the lowest at $30.24.
Does 99252 require prior authorization under Medicaid?
No publishing state flags 99252 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.