The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 99404. 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
28
Median % of Medicare
--
Rate range
$37.95 - $199.82
99404 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alaska | $199.82 | -- | -- | 2026 |
| Arizona | $100.33 | -- | -- | 2024 |
| California | $51.16 | -- | -- | 2026 |
| Colorado | $98.45 | -- | -- | 2026 |
| Connecticut | $100.97 | -- | -- | 2008 |
| District of Columbia | $100.04 | -- | Not required | 2026 |
| Delaware | $90.90 | -- | -- | 2026 |
| Iowa | $42.46 | -- | -- | 2013 |
| Idaho | $121.08 | -- | Not required | 2025 |
| Indiana | $102.29 | -- | -- | 2025 |
| Kansas | $40.00 | -- | -- | 1992 |
| Kentucky | $80.29 | -- | -- | 2026 |
| Louisiana | $49.61 | -- | -- | 2026 |
| Massachusetts | $82.02 | -- | -- | 2026 |
| Maine | $108.19 | -- | -- | 2026 |
| Michigan | $72.21 | -- | -- | 2026 |
| Minnesota | $87.64 | -- | -- | 2026 |
| Montana | $149.72 | -- | -- | 2026 |
| New Hampshire | $61.32 | -- | Not required | 2026 |
| New Jersey | $66.18 | -- | Not required | 2026 |
| New Mexico | $156.65 | -- | -- | 2025 |
| Nevada | $71.73 | -- | -- | 2022 |
| Ohio | $75.59 | -- | -- | 2024 |
| South Carolina | $80.54 | -- | -- | 2024 |
| Vermont | $94.21 | -- | -- | 2026 |
| Wisconsin | $37.95 | -- | -- | 2008 |
| West Virginia | $78.81 | -- | -- | 2026 |
| Wyoming | $105.30 | -- | -- | 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
- 10004 - Needle biopsy without imaging, each added lesion
- 10005 - Needle biopsy with ultrasound guidance, first lesion
- 10006 - Needle biopsy with ultrasound guidance, each added lesion
- 10007 - Needle biopsy with fluoroscopic guidance, first lesion
- 10009 - Needle biopsy with CT guidance, first lesion
- 10011 - Needle biopsy with MRI guidance, first lesion
- 10012 - Needle biopsy with MRI guidance, each added lesion
- 10021 - Fine needle aspiration biopsy, first lesion, no imaging
Frequently asked questions
How much does Medicaid pay for 99404?
28 state Medicaid programs publish a fee-for-service rate for 99404 (preventive counseling, individual, 60 minutes), ranging from $37.95 in Wisconsin to $199.82 in Alaska. The full table on this page lists every publishing state's current rate.
Which state pays the most for 99404?
Alaska publishes the highest Medicaid rate for 99404 at $199.82. Wisconsin publishes the lowest at $37.95.
Does 99404 require prior authorization under Medicaid?
No publishing state flags 99404 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.