The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 99253. 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
$29/mo after the trial. Cancel anytime.
Publishing states
31
Median % of Medicare
--
Rate range
$45.13 - $184.48
99253 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alaska | $184.48 | -- | -- | 2026 |
| Alabama | $74.00 | -- | -- | 2026 |
| Arkansas | $98.56 | -- | -- | 2026 |
| Arizona | $102.55 | -- | -- | 2022 |
| California | $46.44 | -- | -- | 2026 |
| Connecticut | $66.93 | -- | -- | 2012 |
| District of Columbia | $86.34 | -- | Not required | 2026 |
| Florida | $110.91 | -- | -- | 2025 |
| Georgia | $87.91 | -- | -- | 2026 |
| Illinois | $45.20 | -- | -- | 2026 |
| Kentucky | $74.75 | -- | -- | 2026 |
| Massachusetts | $73.87 | -- | -- | 2026 |
| Michigan | $63.05 | -- | -- | 2026 |
| Minnesota | $75.83 | -- | -- | 2026 |
| Mississippi | $93.92 | -- | -- | 2026 |
| North Carolina | $93.14 | -- | -- | 2025 |
| Nebraska | $126.13 | -- | -- | 2026 |
| New Jersey | $111.39 | -- | Not required | 2026 |
| New Mexico | $142.60 | -- | -- | 2025 |
| Nevada | $118.40 | -- | -- | 2024 |
| New York | $45.13 | -- | -- | 2026 |
| Ohio | $57.28 | -- | -- | 2024 |
| Pennsylvania | $78.42 | -- | -- | 2023 |
| South Carolina | $73.18 | -- | -- | 2024 |
| Texas | $83.75* | -- | -- | 2007 |
| Utah | $75.97* | -- | Not required | 2026 |
| Virginia | $71.31* | -- | -- | 2026 |
| Washington | $58.67 | -- | -- | 2026 |
| Wisconsin | $84.56 | -- | -- | 2020 |
| West Virginia | $69.78 | -- | -- | 2026 |
| Wyoming | $115.73 | -- | -- | 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 99253?
31 state Medicaid programs publish a fee-for-service rate for 99253 (inpatient consultation, low complexity), ranging from $45.13 in New York to $184.48 in Alaska. The full table on this page lists every publishing state's current rate.
Which state pays the most for 99253?
Alaska publishes the highest Medicaid rate for 99253 at $184.48. New York publishes the lowest at $45.13.
Does 99253 require prior authorization under Medicaid?
No publishing state flags 99253 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.