The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 99397. 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
43
Median % of Medicare
--
Rate range
$18.53 - $236.99
99397 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alaska | $236.99 | -- | -- | 2026 |
| Arizona | $120.84 | -- | -- | 2024 |
| California | $121.16 | -- | -- | 2026 |
| Colorado | $122.20 | -- | -- | 2026 |
| Connecticut | $95.49 | -- | -- | 2008 |
| District of Columbia | $124.11 | -- | Not required | 2026 |
| Delaware | $135.30 | -- | -- | 2026 |
| Florida | $67.10 | -- | -- | 2026 |
| Georgia | $75.38 | -- | -- | 2026 |
| Hawaii | $98.65 | -- | -- | 2025 |
| Iowa | $94.06 | -- | -- | 2024 |
| Idaho | $111.96 | -- | Not required | 2025 |
| Illinois | $41.35 | -- | -- | 2026 |
| Indiana | $123.85 | -- | -- | 2025 |
| Kansas | $18.53 | -- | -- | 2024 |
| Kentucky | $106.26 | -- | -- | 2026 |
| Louisiana | $81.88 | -- | -- | 2026 |
| Massachusetts | $106.53 | -- | -- | 2026 |
| Maine | $131.98 | -- | -- | 2026 |
| Michigan | $76.91 | -- | -- | 2026 |
| Minnesota | $108.37 | -- | -- | 2026 |
| Missouri | $38.71 | -- | Not required | 2022 |
| Mississippi | $128.43 | -- | -- | 2026 |
| Montana | $182.87 | -- | -- | 2026 |
| North Carolina | $100.21 | -- | -- | 2025 |
| North Dakota | $153.58 | -- | Not required | 2026 |
| Nebraska | $146.25 | -- | -- | 2026 |
| New Hampshire | $44.15 | -- | Not required | 2026 |
| New Jersey | $94.75 | -- | Not required | 2026 |
| New Mexico | $188.54 | -- | -- | 2025 |
| Nevada | $140.00 | -- | -- | 2024 |
| New York | $117.33 | -- | -- | 2026 |
| Ohio | $75.74 | -- | -- | 2024 |
| Oklahoma | $122.44 | -- | -- | 2026 |
| Rhode Island | $101.35 | -- | -- | 2026 |
| South Carolina | $97.20 | -- | -- | 2024 |
| Texas | $85.65* | -- | -- | 2010 |
| Utah | $105.54* | -- | Not required | 2026 |
| Virginia | $100.22* | -- | -- | 2026 |
| Vermont | $116.01 | -- | -- | 2026 |
| Wisconsin | $89.57 | -- | -- | 2024 |
| West Virginia | $95.16 | -- | -- | 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 99397?
43 state Medicaid programs publish a fee-for-service rate for 99397 (preventive visit, established patient, age 65+), ranging from $18.53 in Kansas to $236.99 in Alaska. The full table on this page lists every publishing state's current rate.
Which state pays the most for 99397?
Alaska publishes the highest Medicaid rate for 99397 at $236.99. Kansas publishes the lowest at $18.53.
Does 99397 require prior authorization under Medicaid?
No publishing state flags 99397 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.