The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 99385. 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 - $228.93
99385 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alaska | $228.93 | -- | -- | 2026 |
| Alabama | $88.00* | -- | -- | 2026 |
| Arkansas | $61.01 | -- | -- | 2026 |
| Arizona | $117.15 | -- | -- | 2024 |
| California | $144.10 | -- | -- | 2026 |
| Colorado | $119.93 | -- | -- | 2026 |
| Connecticut | $156.16 | -- | -- | 2026 |
| District of Columbia | $120.28 | -- | Not required | 2026 |
| Delaware | $131.37 | -- | -- | 2026 |
| Florida | $64.34 | -- | -- | 2026 |
| Georgia | $75.38 | -- | -- | 2026 |
| Hawaii | $94.46 | -- | -- | 2025 |
| Iowa | $88.58 | -- | -- | 2024 |
| Idaho | $129.26 | -- | Not required | 2025 |
| Illinois | $32.15 | -- | -- | 2014 |
| Indiana | $120.02 | -- | -- | 2025 |
| Kansas | $32.70 | -- | -- | 2024 |
| Kentucky | $95.21 | -- | -- | 2026 |
| Louisiana | $76.67 | -- | -- | 2026 |
| Massachusetts | $103.30 | -- | -- | 2026 |
| Maine | $61.43 | -- | -- | 2010 |
| Michigan | $69.00 | -- | -- | 2026 |
| Minnesota | $104.96 | -- | -- | 2026 |
| Missouri | $52.42 | -- | Not required | 2022 |
| Mississippi | $124.61 | -- | -- | 2026 |
| Montana | $176.96 | -- | -- | 2026 |
| North Carolina | $93.93 | -- | -- | 2025 |
| North Dakota | $148.69 | -- | Not required | 2026 |
| Nebraska | $172.84 | -- | -- | 2026 |
| New Hampshire | $44.15 | -- | Not required | 2026 |
| New Jersey | $92.67 | -- | Not required | 2026 |
| New Mexico | $182.82 | -- | -- | 2025 |
| Nevada | $136.00 | -- | -- | 2024 |
| New York | $113.55 | -- | -- | 2026 |
| Ohio | $78.10 | -- | -- | 2024 |
| Oklahoma | $118.55 | -- | -- | 2026 |
| Pennsylvania | $20.00 | -- | -- | 2025 |
| Rhode Island | $101.35 | -- | -- | 2026 |
| South Carolina | $94.22 | -- | -- | 2024 |
| Texas | $85.29* | -- | -- | 2023 |
| Utah | $102.21* | -- | Not required | 2026 |
| Virginia | $97.09* | -- | -- | 2026 |
| Vermont | $112.62 | -- | -- | 2026 |
| Washington | $94.78* | -- | -- | 2026 |
| Wisconsin | $86.78 | -- | -- | 2024 |
| West Virginia | $92.23 | -- | -- | 2026 |
| Wyoming | $108.18* | -- | -- | 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 99385?
47 state Medicaid programs publish a fee-for-service rate for 99385 (preventive visit, new patient, age 18-39), ranging from $20.00 in Pennsylvania to $228.93 in Alaska. The full table on this page lists every publishing state's current rate.
Which state pays the most for 99385?
Alaska publishes the highest Medicaid rate for 99385 at $228.93. Pennsylvania publishes the lowest at $20.00.
Does 99385 require prior authorization under Medicaid?
No publishing state flags 99385 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.