P9058 Medicaid Rate by State

Red blood cells, leukocytes reduced, cmv-negative, irradiated, each unit

15 state Medicaid programs publish a fee-for-service rate for P9058 (red blood cells, leukocytes reduced, cmv-negative, irradiated, each unit), ranging from $22.01 in Montana to $442.98 in Rhode Island.

Every state, kept current

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This page shows one representative rate per state for P9058. Full schedules include every locality, modifier, and age-band variant.

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Publishing states

15

Median % of Medicare

--

Rate range

$22.01 - $442.98

P9058 rates in every publishing state

StateMedicaid rate% of MedicarePrior authVintage
Arizona$176.81----2021
California$263.49----2026
Indiana$324.32----2026
Kansas$87.00----2004
Michigan$130.44----2026
Missouri$220.05--Not required2026
Mississippi$185.38----2026
Montana$22.01----2026
New Hampshire$433.57--Not required2026
New Mexico$293.92----2026
Nevada$296.45----2008
Oklahoma$225.26----2026
Pennsylvania$30.00----2005
Rhode Island$442.98----2026
Texas$206.67*----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 lab & imaging codes

All 40 codes from P9010 to P9615 or every lab & imaging code by number.

Frequently asked questions

How much does Medicaid pay for P9058?

15 state Medicaid programs publish a fee-for-service rate for P9058 (red blood cells, leukocytes reduced, cmv-negative, irradiated, each unit), ranging from $22.01 in Montana to $442.98 in Rhode Island. The full table on this page lists every publishing state's current rate.

Which state pays the most for P9058?

Rhode Island publishes the highest Medicaid rate for P9058 at $442.98. Montana publishes the lowest at $22.01.

Does P9058 require prior authorization under Medicaid?

No publishing state flags P9058 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.