Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for G9012. 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
15
Median % of Medicare
--
Rate range
$11.19 - $1,485.61
G9012 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| California | $166.70 | -- | -- | 2026 |
| Colorado | $60.05 | -- | -- | 2026 |
| Connecticut | $17.09 | -- | -- | 2021 |
| District of Columbia | $1,485.61 | -- | Not required | 2025 |
| Maine | $25.92* | -- | -- | 2026 |
| Michigan | $65.00 | -- | -- | 2026 |
| Minnesota | $20.60 | -- | -- | 2004 |
| Missouri | $21.40 | -- | Not required | 2019 |
| North Carolina | $12.96 | -- | -- | 2022 |
| Pennsylvania | $46.20 | -- | -- | 2025 |
| Texas | $240.97* | -- | -- | 2014 |
| Virginia | $258.80 | -- | -- | 2025 |
| Vermont | $30.00 | -- | -- | 2004 |
| Washington | $11.19 | -- | -- | 2026 |
| Wyoming | $18.05* | -- | -- | 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 2 codes from G9012 to G9157 or every physician code by number.
Frequently asked questions
How much does Medicaid pay for G9012?
15 state Medicaid programs publish a fee-for-service rate for G9012 (other specified case management service not elsewhere classified), ranging from $11.19 in Washington to $1,485.61 in District of Columbia. The full table on this page lists every publishing state's current rate.
Which state pays the most for G9012?
District of Columbia publishes the highest Medicaid rate for G9012 at $1,485.61. Washington publishes the lowest at $11.19.
Does G9012 require prior authorization under Medicaid?
No publishing state flags G9012 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.