The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 99395. 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
$18.53 - $206.91
99395 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alaska | $206.91 | -- | -- | 2026 |
| Alabama | $88.00* | -- | -- | 2026 |
| Arkansas | $61.01 | -- | -- | 2026 |
| Arizona | $105.48 | -- | -- | 2024 |
| California | $129.90 | -- | -- | 2026 |
| Colorado | $104.99 | -- | -- | 2026 |
| Connecticut | $128.74 | -- | -- | 2026 |
| District of Columbia | $108.58 | -- | Not required | 2026 |
| Delaware | $118.37 | -- | -- | 2026 |
| Florida | $58.82 | -- | -- | 2026 |
| Georgia | $75.38 | -- | -- | 2026 |
| Hawaii | $86.32 | -- | -- | 2025 |
| Iowa | $76.23 | -- | -- | 2024 |
| Idaho | $111.96 | -- | Not required | 2025 |
| Illinois | $32.15 | -- | -- | 2009 |
| Indiana | $108.26 | -- | -- | 2025 |
| Kansas | $18.53 | -- | -- | 2024 |
| Kentucky | $84.80 | -- | -- | 2026 |
| Louisiana | $66.65 | -- | -- | 2026 |
| Massachusetts | $93.08 | -- | -- | 2026 |
| Maine | $58.74 | -- | -- | 2010 |
| Michigan | $61.08 | -- | -- | 2026 |
| Minnesota | $94.72 | -- | -- | 2026 |
| Missouri | $38.71 | -- | Not required | 2022 |
| Mississippi | $112.36 | -- | -- | 2026 |
| Montana | $159.71 | -- | -- | 2026 |
| North Carolina | $81.61 | -- | -- | 2025 |
| North Dakota | $134.05 | -- | Not required | 2026 |
| Nebraska | $132.96 | -- | -- | 2026 |
| New Hampshire | $44.15 | -- | Not required | 2026 |
| New Jersey | $88.41 | -- | Not required | 2026 |
| New Mexico | $164.98 | -- | -- | 2025 |
| Nevada | $121.97 | -- | -- | 2024 |
| New York | $104.28 | -- | -- | 2026 |
| Ohio | $64.82 | -- | -- | 2024 |
| Oklahoma | $107.12 | -- | -- | 2026 |
| Pennsylvania | $20.00 | -- | -- | 2025 |
| Rhode Island | $101.35 | -- | -- | 2026 |
| South Carolina | $94.40 | -- | -- | 2024 |
| Texas | $74.02* | -- | -- | 2023 |
| Utah | $92.34* | -- | Not required | 2026 |
| Virginia | $87.70* | -- | -- | 2026 |
| Vermont | $101.44 | -- | -- | 2026 |
| Washington | $85.44* | -- | -- | 2026 |
| Wisconsin | $78.16 | -- | -- | 2024 |
| West Virginia | $83.69 | -- | -- | 2026 |
| Wyoming | $95.60* | -- | -- | 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 99395?
47 state Medicaid programs publish a fee-for-service rate for 99395 (preventive visit, established patient, age 18-39), ranging from $18.53 in Kansas to $206.91 in Alaska. The full table on this page lists every publishing state's current rate.
Which state pays the most for 99395?
Alaska publishes the highest Medicaid rate for 99395 at $206.91. Kansas publishes the lowest at $18.53.
Does 99395 require prior authorization under Medicaid?
No publishing state flags 99395 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.