Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for G0423. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
- Full-schedule CSV export and state network lists
- Email alerts when a state changes its rates
$29/mo after the trial. Cancel anytime.
Publishing states
14
Median % of Medicare
63.8%
Rate range
$33.57 - $176.96
G0423 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| California | $94.80 | 72% | -- | 2026 |
| Colorado | $33.57 | 25.5% | -- | 2026 |
| District of Columbia | $117.02 | 88.9% | Not required | 2026 |
| Iowa | $37.15 | 28.2% | -- | 2024 |
| Illinois | $83.34 | 63.3% | -- | 2024 |
| Michigan | $83.92 | 63.8% | -- | 2026 |
| Minnesota | $100.34 | 76.2% | Conditional | 2026 |
| Montana | $176.96 | 134.5% | -- | 2026 |
| New Hampshire | $56.17 | 42.7% | Not required | 2026 |
| New Jersey | $66.58 | 50.6% | Not required | 2026 |
| New Mexico | $38.36 | -- | -- | 2026 |
| Oregon | $106.20* | 80.7% | -- | 2026 |
| Washington | $79.31 | 60.3% | -- | 2026 |
| West Virginia | $90.77 | 69% | -- | 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
All 136 codes from G0008 to G0659 or every physician code by number.
Frequently asked questions
How much does Medicaid pay for G0423?
14 state Medicaid programs publish a fee-for-service rate for G0423 (intensive cardiac rehabilitation; with or without continuous ecg monitoring; without exercise, per session), ranging from $33.57 in Colorado to $176.96 in Montana, with a median of 63.8% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for G0423?
Montana publishes the highest Medicaid rate for G0423 at $176.96 (134.5% of the national Medicare amount). Colorado publishes the lowest at $33.57.
Does G0423 require prior authorization under Medicaid?
1 of the 14 publishing states flag G0423 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".