The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 99396. 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
45
Median % of Medicare
--
Rate range
$18.53 - $220.60
99396 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alaska | $220.60 | -- | -- | 2026 |
| Arizona | $112.24 | -- | -- | 2024 |
| California | $112.20 | -- | -- | 2026 |
| Colorado | $114.34 | -- | -- | 2026 |
| Connecticut | $141.67 | -- | -- | 2026 |
| District of Columbia | $115.00 | -- | Not required | 2026 |
| Delaware | $125.54 | -- | -- | 2026 |
| Florida | $63.88 | -- | -- | 2026 |
| Georgia | $75.38 | -- | -- | 2026 |
| Hawaii | $93.79 | -- | -- | 2025 |
| Iowa | $84.97 | -- | -- | 2024 |
| Idaho | $111.96 | -- | Not required | 2025 |
| Illinois | $41.35 | -- | -- | 2012 |
| Indiana | $115.14 | -- | -- | 2025 |
| Kansas | $18.53 | -- | -- | 2024 |
| Kentucky | $100.83 | -- | -- | 2026 |
| Louisiana | $73.03 | -- | -- | 2026 |
| Massachusetts | $99.00 | -- | -- | 2026 |
| Maine | $122.50 | -- | -- | 2026 |
| Michigan | $69.00 | -- | -- | 2026 |
| Minnesota | $100.23 | -- | -- | 2026 |
| Missouri | $38.71 | -- | Not required | 2022 |
| Mississippi | $119.34 | -- | -- | 2026 |
| Montana | $169.70 | -- | -- | 2026 |
| North Carolina | $89.32 | -- | -- | 2025 |
| North Dakota | $142.31 | -- | Not required | 2026 |
| Nebraska | $139.60 | -- | -- | 2026 |
| New Hampshire | $44.15 | -- | Not required | 2026 |
| New Jersey | $88.54 | -- | Not required | 2026 |
| New Mexico | $175.60 | -- | -- | 2025 |
| Nevada | $129.99 | -- | -- | 2024 |
| New York | $108.89 | -- | -- | 2026 |
| Ohio | $70.44 | -- | -- | 2024 |
| Oklahoma | $113.74 | -- | -- | 2026 |
| Pennsylvania | $20.00 | -- | -- | 2023 |
| Rhode Island | $101.35 | -- | -- | 2026 |
| South Carolina | $90.45 | -- | -- | 2024 |
| Texas | $76.37* | -- | -- | 2016 |
| Utah | $97.99* | -- | Not required | 2026 |
| Virginia | $93.00* | -- | -- | 2026 |
| Vermont | $107.52 | -- | -- | 2026 |
| Washington | $90.55* | -- | -- | 2026 |
| Wisconsin | $83.07 | -- | -- | 2024 |
| West Virginia | $88.57 | -- | -- | 2026 |
| Wyoming | $103.14 | -- | -- | 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 99396?
45 state Medicaid programs publish a fee-for-service rate for 99396 (preventive visit, established patient, age 40-64), ranging from $18.53 in Kansas to $220.60 in Alaska. The full table on this page lists every publishing state's current rate.
Which state pays the most for 99396?
Alaska publishes the highest Medicaid rate for 99396 at $220.60. Kansas publishes the lowest at $18.53.
Does 99396 require prior authorization under Medicaid?
No publishing state flags 99396 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.