New York Medicaid Lab & Imaging Fee Schedule 2026

New York Medicaid publishes 627 lab & imaging procedure rates effective 2026, paying a median 95.7% 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 New York lab & imaging schedule has 627 codes.

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Published codes

627

Lab & Imaging procedures on the 2026 schedule

Median % of Medicare

95.7%

vs national Medicare, GPCI-neutral

Effective vintage

2026

latest effective year on the schedule

Common lab & imaging procedures and what New York Medicaid pays

A curated sample of recognizable procedures from the 627-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.

CodeProcedureNew York rate% of Medicare
70110Jaw (mandible) X-ray, 4 or more views$39.8392.4%
70140Facial bone X-ray, under 3 views$29.2692.2%
70160Nasal bone X-ray$34.8193%
70220Sinus X-ray, 3 or more views$34.3991.1%
70360Neck soft tissue X-ray$28.6692.3%
70450CT scan of the head without contrast$127.28119.5%
70480CT scan of the eye socket or inner ear without contrast$204.21129%
70486CT scan of the face and sinuses without contrast$198.49154.8%
70491CT scan of neck soft tissue with contrast$200.39109.3%
70551MRI of the brain without contrast$334.43171.2%
70553MRI of the brain without then with contrast$514.84162.4%
71045Chest X-ray, 1 view$23.4692.4%
71046Chest X-ray, 2 views$30.4292%
71047Chest X-ray, 3 views$38.2693.1%
71048Chest X-ray, 4 or more views$41.8592.8%
71100Rib X-ray, one side$33.4792.8%
71250CT scan of the chest without contrast$199.30150.3%
71260CT scan of the chest with contrast$201.45120.9%
71275CT angiography of the chest$340.21121.3%
72040Neck (cervical) spine X-ray, 2-3 views$35.9290.4%
72070Mid-back (thoracic) spine X-ray, 2 views$29.8590.3%
72100Lower back (lumbar) spine X-ray, 2-3 views$36.2389.7%
72110Lower back (lumbar) spine X-ray, 4 or more views$46.5487.1%
72125CT scan of the neck (cervical) spine without contrast$199.30152.6%
72131CT scan of the lower (lumbar) spine without contrast$199.30153.4%

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 New York Medicaid fee schedules

Lab & Imaging rates in neighboring states

Frequently asked questions

What does New York Medicaid pay for laboratory tests and imaging?

New York Medicaid publishes 627 lab & imaging procedure rates effective 2026, paying a median 95.7% 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 New York's lab & imaging rates compare with Medicare?

Across lab & imaging codes with a national Medicare comparator, New York Medicaid pays a median 95.7% 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 New York?

New York does not publish prior-authorization indicators on this fee schedule, so PA requirements must be confirmed through the state's provider manual or portal. Absence of a flag here means "not published", never "no PA required".

Where do these rates come from?

Directly from New York'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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