A9542 Medicaid Rate by State

Indium in-111 ibritumomab tiuxetan, diagnostic, per study dose, up to 5 millicuries

12 state Medicaid programs publish a fee-for-service rate for A9542 (indium in-111 ibritumomab tiuxetan, diagnostic, per study dose, up to 5 millicuries), ranging from $758.12 in Arizona to $3,990.00 in Montana.

Every state, kept current

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This page shows one representative rate per state for A9542. Full schedules include every locality, modifier, and age-band variant.

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Publishing states

12

Median % of Medicare

--

Rate range

$758.12 - $3,990.00

A9542 rates in every publishing state

StateMedicaid rate% of MedicarePrior authVintage
Arkansas$1,808.00----2026
Arizona$758.12----2026
California$3,490.46----2026
Idaho$3,447.36--Not required2025
Indiana$2,314.08----2026
Kentucky$798.02----2026
Montana$3,990.00----2026
New Mexico$2,935.79----2025
Nevada$1,421.07----2024
Texas$2,935.79*----2026
Washington$3,990.00----2026
Wisconsin$2,215.70----2008

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 dme & supplies codes

All 76 codes from A9274 to A9800 or every dme & supplies code by number.

Frequently asked questions

How much does Medicaid pay for A9542?

12 state Medicaid programs publish a fee-for-service rate for A9542 (indium in-111 ibritumomab tiuxetan, diagnostic, per study dose, up to 5 millicuries), ranging from $758.12 in Arizona to $3,990.00 in Montana. The full table on this page lists every publishing state's current rate.

Which state pays the most for A9542?

Montana publishes the highest Medicaid rate for A9542 at $3,990.00. Arizona publishes the lowest at $758.12.

Does A9542 require prior authorization under Medicaid?

No publishing state flags A9542 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.