The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 99358. 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
$41.32 - $212.80
99358 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $99.06 | -- | -- | 2022 |
| California | $81.58 | -- | -- | 2026 |
| Hawaii | $88.74 | -- | -- | 2025 |
| Iowa | $87.35 | -- | -- | 2024 |
| Kentucky | $105.00 | -- | -- | 2026 |
| Massachusetts | $67.76 | -- | -- | 2026 |
| Maine | $63.87 | -- | -- | 2026 |
| Montana | $121.11 | -- | -- | 2026 |
| New Hampshire | $41.32 | -- | Not required | 2026 |
| New Jersey | $91.71 | -- | Not required | 2026 |
| New Mexico | $127.74 | -- | -- | 2025 |
| South Carolina | $84.44* | -- | -- | 2020 |
| Texas | $99.53* | -- | -- | 2023 |
| Utah | $70.49* | -- | Not required | 2026 |
| Vermont | $76.24 | -- | -- | 2026 |
| Wisconsin | $212.80 | -- | -- | 2006 |
| West Virginia | $64.66 | -- | -- | 2026 |
| Wyoming | $105.30 | -- | -- | 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 99358?
18 state Medicaid programs publish a fee-for-service rate for 99358 (prolonged service without direct patient contact, first hour), ranging from $41.32 in New Hampshire to $212.80 in Wisconsin. The full table on this page lists every publishing state's current rate.
Which state pays the most for 99358?
Wisconsin publishes the highest Medicaid rate for 99358 at $212.80. New Hampshire publishes the lowest at $41.32.
Does 99358 require prior authorization under Medicaid?
No publishing state flags 99358 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.