The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 99391. 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 - $171.68
99391 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alaska | $171.68 | -- | -- | 2026 |
| Alabama | $88.00* | -- | -- | 2026 |
| Arkansas | $61.01 | -- | -- | 2026 |
| Arizona | $88.87 | -- | -- | 2024 |
| California | $109.69 | -- | -- | 2026 |
| Colorado | $87.44 | -- | -- | 2026 |
| Connecticut | $63.81 | -- | -- | 2008 |
| District of Columbia | $91.96 | -- | Not required | 2026 |
| Delaware | $99.81 | -- | -- | 2026 |
| Florida | $48.92 | -- | -- | 2026 |
| Georgia | $99.99* | -- | -- | 2026 |
| Hawaii | $67.37 | -- | -- | 2025 |
| Iowa | $62.86 | -- | -- | 2024 |
| Idaho | $85.88 | -- | Not required | 2025 |
| Illinois | $31.28 | -- | -- | 2026 |
| Indiana | $91.11 | -- | -- | 2025 |
| Kansas | $28.34 | -- | -- | 2024 |
| Kentucky | $67.57 | -- | -- | 2026 |
| Louisiana | $78.13 | -- | -- | 2026 |
| Massachusetts | $78.16 | -- | -- | 2026 |
| Maine | $58.37 | -- | -- | 2010 |
| Michigan | $45.89 | -- | -- | 2026 |
| Minnesota | $80.29 | -- | -- | 2026 |
| Missouri | $24.20 | -- | Not required | 2022 |
| Mississippi | $94.32 | -- | -- | 2026 |
| Montana | $133.41 | -- | -- | 2026 |
| North Carolina | $66.41 | -- | -- | 2025 |
| North Dakota | $113.40 | -- | Not required | 2026 |
| Nebraska | $107.18* | -- | -- | 2026 |
| New Hampshire | $67.95 | -- | Not required | 2026 |
| New Jersey | $79.04 | -- | Not required | 2026 |
| New Mexico | $138.34 | -- | -- | 2025 |
| Nevada | $102.70 | -- | -- | 2024 |
| New York | $85.60 | -- | -- | 2026 |
| Ohio | $58.57 | -- | -- | 2026 |
| Oklahoma | $90.02 | -- | -- | 2026 |
| Pennsylvania | $20.00 | -- | -- | 2023 |
| Rhode Island | $101.35 | -- | -- | 2026 |
| South Carolina | $79.29 | -- | -- | 2024 |
| Texas | $82.42 | -- | -- | 2023 |
| Utah | $77.73* | -- | Not required | 2026 |
| Virginia | $73.96* | -- | -- | 2026 |
| Vermont | $85.74 | -- | -- | 2026 |
| Washington | $70.75 | -- | -- | 2026 |
| Wisconsin | $65.77 | -- | -- | 2024 |
| West Virginia | $69.78 | -- | -- | 2026 |
| Wyoming | $78.35* | -- | -- | 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 99391?
47 state Medicaid programs publish a fee-for-service rate for 99391 (preventive visit, established patient, under 1 year), ranging from $20.00 in Pennsylvania to $171.68 in Alaska. The full table on this page lists every publishing state's current rate.
Which state pays the most for 99391?
Alaska publishes the highest Medicaid rate for 99391 at $171.68. Pennsylvania publishes the lowest at $20.00.
Does 99391 require prior authorization under Medicaid?
No publishing state flags 99391 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.