The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 99381. 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
47
Median % of Medicare
--
Rate range
$20.00 - $190.92
99381 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alaska | $190.92 | -- | -- | 2026 |
| Alabama | $88.00* | -- | -- | 2026 |
| Arkansas | $61.01 | -- | -- | 2026 |
| Arizona | $98.71 | -- | -- | 2024 |
| California | $122.33 | -- | -- | 2026 |
| Colorado | $97.23 | -- | -- | 2026 |
| Connecticut | $84.52 | -- | -- | 2008 |
| District of Columbia | $101.91 | -- | Not required | 2026 |
| Delaware | $110.55 | -- | -- | 2026 |
| Florida | $53.31 | -- | -- | 2026 |
| Georgia | $107.75* | -- | -- | 2026 |
| Hawaii | $73.80 | -- | -- | 2025 |
| Iowa | $77.02 | -- | -- | 2024 |
| Idaho | $103.92 | -- | Not required | 2025 |
| Illinois | $91.90 | -- | -- | 2024 |
| Indiana | $101.27 | -- | -- | 2025 |
| Kansas | $43.60 | -- | -- | 2024 |
| Kentucky | $78.58 | -- | -- | 2026 |
| Louisiana | $86.82 | -- | -- | 2026 |
| Massachusetts | $86.71 | -- | -- | 2026 |
| Maine | $62.06 | -- | -- | 2010 |
| Michigan | $53.49 | -- | -- | 2026 |
| Minnesota | $88.95 | -- | -- | 2026 |
| Missouri | $37.08 | -- | Not required | 2022 |
| Mississippi | $104.42 | -- | -- | 2026 |
| Montana | $148.85 | -- | -- | 2026 |
| North Carolina | $79.65 | -- | -- | 2025 |
| North Dakota | $125.79 | -- | Not required | 2026 |
| Nebraska | $127.28* | -- | -- | 2026 |
| New Hampshire | $49.05 | -- | Not required | 2026 |
| New Jersey | $84.65 | -- | Not required | 2026 |
| New Mexico | $180.42 | -- | -- | 2023 |
| Nevada | $114.16 | -- | -- | 2024 |
| New York | $95.50 | -- | -- | 2026 |
| Ohio | $73.03 | -- | -- | 2026 |
| Oklahoma | $99.66 | -- | -- | 2026 |
| Pennsylvania | $20.00 | -- | -- | 2023 |
| Rhode Island | $101.35 | -- | -- | 2026 |
| South Carolina | $79.37 | -- | -- | 2024 |
| Texas | $89.58 | -- | -- | 2023 |
| Utah | $86.07* | -- | Not required | 2026 |
| Virginia | $81.91* | -- | -- | 2026 |
| Vermont | $95.07 | -- | -- | 2026 |
| Washington | $78.59 | -- | -- | 2026 |
| Wisconsin | $73.06 | -- | -- | 2024 |
| West Virginia | $77.10 | -- | -- | 2026 |
| Wyoming | $90.93* | -- | -- | 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 99381?
47 state Medicaid programs publish a fee-for-service rate for 99381 (preventive visit, new patient, under 1 year), ranging from $20.00 in Pennsylvania to $190.92 in Alaska. The full table on this page lists every publishing state's current rate.
Which state pays the most for 99381?
Alaska publishes the highest Medicaid rate for 99381 at $190.92. Pennsylvania publishes the lowest at $20.00.
Does 99381 require prior authorization under Medicaid?
No publishing state flags 99381 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.