The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 99454. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
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- Full state Medicaid dental network lists
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Publishing states
29
Median % of Medicare
80.1%
Rate range
$32.87 - $60.40
99454 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $48.42 | 92.9% | -- | 2022 |
| California | $58.92 | 113.1% | -- | 2026 |
| Colorado | $36.76 | 70.6% | -- | 2026 |
| Hawaii | $54.12 | 103.9% | -- | 2025 |
| Iowa | $47.02 | 90.2% | -- | 2024 |
| Idaho | $41.29 | 79.3% | Not required | 2026 |
| Indiana | $42.73 | 82% | Required | 2025 |
| Kentucky | $37.46 | 71.9% | -- | 2026 |
| Massachusetts | $39.57 | 76% | -- | 2026 |
| Maine | $34.64 | 66.5% | -- | 2026 |
| Michigan | $33.23 | 63.8% | -- | 2026 |
| Minnesota | $41.72 | 80.1% | Conditional | 2026 |
| Mississippi | $36.72 | 70.5% | -- | 2026 |
| Montana | $60.40 | 115.9% | -- | 2026 |
| North Carolina | $52.37 | 100.5% | -- | 2025 |
| Nebraska | $47.10 | 90.4% | -- | 2026 |
| New Hampshire | $39.31 | 75.5% | Not required | 2026 |
| New Jersey | $42.29 | 81.2% | Not required | 2026 |
| New York | $49.40 | 94.8% | -- | 2026 |
| Ohio | $47.09 | 90.4% | -- | 2019 |
| Oregon | $42.46* | 81.5% | -- | 2026 |
| Pennsylvania | $38.27 | 73.5% | -- | 2026 |
| Rhode Island | $50.48 | 96.9% | -- | 2026 |
| Virginia | $37.58* | 72.1% | -- | 2026 |
| Vermont | $40.07 | 76.9% | -- | 2026 |
| Washington | $32.87 | 63.1% | -- | 2026 |
| Wisconsin | $51.55 | 98.9% | -- | 2020 |
| West Virginia | $33.18 | 63.7% | -- | 2026 |
| Wyoming | $38.65 | 74.2% | -- | 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 99454?
29 state Medicaid programs publish a fee-for-service rate for 99454 (remote monitoring device supply, per 30 days), ranging from $32.87 in Washington to $60.40 in Montana, with a median of 80.1% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for 99454?
Montana publishes the highest Medicaid rate for 99454 at $60.40 (115.9% of the national Medicare amount). Washington publishes the lowest at $32.87.
Does 99454 require prior authorization under Medicaid?
2 of the 29 publishing states flag 99454 as requiring prior authorization (always or conditionally) on their fee schedules. States without a flag publish no PA indicator for this code - that means "not published", not "no PA required".