District of Columbia Medicaid Lab & Imaging Fee Schedule 2026

District of Columbia Medicaid publishes 1,998 lab & imaging procedure rates effective 2026, paying a median 80% of the national Medicare amount for the same services. This page shows published rates for common lab & imaging procedures with plain-language descriptions and, where a comparator exists, each rate as a percentage of national Medicare.

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The table on this page is a common-procedure sample. The full District of Columbia lab & imaging schedule has 1,998 codes.

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Published codes

1,998

Lab & Imaging procedures on the 2026 schedule

Median % of Medicare

80%

vs national Medicare, GPCI-neutral

PA required

63

+6 conditional or varies

Common lab & imaging procedures and what District of Columbia Medicaid pays

A curated sample of recognizable procedures from the 1,998-code schedule. Rates are the state's published fee-for-service amounts; the percentage compares each rate with the national Medicare amount for the same code.

CodeProcedureDistrict of Columbia rate% of Medicare
70110Jaw (mandible) X-ray, 4 or more views$39.7892.3%
70140Facial bone X-ray, under 3 views$29.2492.2%
70160Nasal bone X-ray$34.6692.6%
70220Sinus X-ray, 3 or more views$34.8492.3%
70360Neck soft tissue X-ray$28.6492.2%
70450CT scan of the head without contrast$97.5691.6%
70480CT scan of the eye socket or inner ear without contrast$144.9091.5%
70486CT scan of the face and sinuses without contrast$118.0292%
70491CT scan of neck soft tissue with contrast$168.1891.7%
70551MRI of the brain without contrast$179.1991.7%
70553MRI of the brain without then with contrast$291.0591.8%
71045Chest X-ray, 1 view$23.2991.8%
71046Chest X-ray, 2 views$30.4392%
71047Chest X-ray, 3 views$37.8292.1%
71048Chest X-ray, 4 or more views$41.4591.9%
71100Rib X-ray, one side$33.2692.2%
71250CT scan of the chest without contrast$121.3691.5%
71260CT scan of the chest with contrast$153.1791.9%
71275CT angiography of the chest$258.3092.1%
72040Neck (cervical) spine X-ray, 2-3 views$36.7392.4%
72070Mid-back (thoracic) spine X-ray, 2 views$30.4692.1%
72100Lower back (lumbar) spine X-ray, 2-3 views$37.3692.5%
72110Lower back (lumbar) spine X-ray, 4 or more views$49.4892.6%
72125CT scan of the neck (cervical) spine without contrast$119.7091.7%
72131CT scan of the lower (lumbar) spine without contrast$119.0891.6%

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 * show the schedule's representative published variant.

More District of Columbia Medicaid fee schedules

Lab & Imaging rates in neighboring states

Frequently asked questions

What does District of Columbia Medicaid pay for laboratory tests and imaging?

District of Columbia Medicaid publishes 1,998 lab & imaging procedure rates effective 2026, paying a median 80% of the national Medicare amount for the same services. The schedule covers blood panels, urinalysis, X-rays, CT, MRI, and ultrasound. The table on this page shows published rates for common procedures; the complete all-codes schedule is available as a CSV download with a ProviderSignal Rates subscription.

How do District of Columbia's lab & imaging rates compare with Medicare?

Across lab & imaging codes with a national Medicare comparator, District of Columbia Medicaid pays a median 80% of the Medicare amount (GPCI-neutral national comparison). Individual codes vary widely, so check the per-code percentage in the table.

Do lab & imaging services need prior authorization in District of Columbia?

District of Columbia publishes prior-authorization flags on its schedule: 63 lab & imaging codes are marked as always requiring PA. Codes without a flag carry no published PA indicator.

Where do these rates come from?

Directly from District of Columbia's published Medicaid fee-for-service schedule (effective 2026), collected and normalized by ProviderSignal across all 50 states + DC. Rates are re-collected on a rolling schedule and this page updates automatically. Procedure descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.

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