Every state, kept current
The Rates plan
$29/mo7-day free trialThe table on this page is a common-procedure sample. The full Pennsylvania lab & imaging schedule has 1,500 codes.
- Every code on all 51 published schedules
- Full-schedule CSV export and state network lists
- Email alerts when a state changes its rates
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Published codes
1,500
Lab & Imaging procedures on the 2026 schedule
Median % of Medicare
80%
vs national Medicare, GPCI-neutral
Effective vintage
2026
latest effective year on the schedule
Pennsylvania publishes facility schedules (including inpatient rate files) alongside its professional fee schedule. Facility-grain rows keep their published rates but are excluded from Medicare-percentage comparisons.
Common lab & imaging procedures and what Pennsylvania Medicaid pays
A curated sample of recognizable procedures from the 1,500-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.
| Code | Procedure | Pennsylvania rate | % of Medicare |
|---|---|---|---|
| 70100 | Jaw (mandible) X-ray, up to 3 views | $24.92 | 61.7% |
| 70110 | Jaw (mandible) X-ray, 4 or more views | $27.50 | 63.8% |
| 70140 | Facial bone X-ray, under 3 views | $27.44 | 86.5% |
| 70150 | Facial bone X-ray, complete, 3 or more views | $34.26 | 73.3% |
| 70160 | Nasal bone X-ray | $19.00 | 50.8% |
| 70200 | Eye socket X-ray, complete, 4 or more views | $33.86 | 72.4% |
| 70210 | Sinus X-ray, up to 2 views | $24.31 | 75% |
| 70220 | Sinus X-ray, 3 or more views | $33.88 | 89.8% |
| 70250 | Skull X-ray, up to 3 views | $31.79 | 88.9% |
| 70328 | Jaw joint (TMJ) X-ray, one side | $24.92 | 73.1% |
| 70330 | Jaw joint (TMJ) X-ray, both sides | $27.50 | 51.5% |
| 70360 | Neck soft tissue X-ray | $17.50 | 56.3% |
| 70450 | CT scan of the head without contrast | $116.75 | 109.6% |
| 70480 | CT scan of the eye socket or inner ear without contrast | $173.43 | 109.5% |
| 70486 | CT scan of the face and sinuses without contrast | $130.00 | 101.4% |
| 70491 | CT scan of neck soft tissue with contrast | $137.50 | 75% |
| 70551 | MRI of the brain without contrast | $337.61 | 172.8% |
| 70553 | MRI of the brain without then with contrast | $339.00 | 107% |
| 71045 | Chest X-ray, 1 view | $15.48 | 61% |
| 71046 | Chest X-ray, 2 views | $23.64 | 71.5% |
| 71047 | Chest X-ray, 3 views | $30.21 | 73.5% |
| 71048 | Chest X-ray, 4 or more views | $32.43 | 71.9% |
| 71100 | Rib X-ray, one side | $26.50 | 73.5% |
| 71101 | Rib X-ray, one side, with chest view | $26.50 | 63.5% |
| 71110 | Rib X-ray, both sides, 3 views | $27.50 | 64.3% |
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 Pennsylvania Medicaid fee schedules
- Pennsylvania Medicaid fee schedule 2026, all categories
- Pennsylvania physician fee schedule · 4,676 codes
- Pennsylvania dme & supplies fee schedule · 1,408 codes
- Pennsylvania state-specific services fee schedule · 62 codes
- Pennsylvania vision fee schedule · 40 codes
- Pennsylvania behavioral health fee schedule · 26 codes
- Pennsylvania hearing fee schedule · 24 codes
Lab & Imaging rates in neighboring states
Frequently asked questions
What does Pennsylvania Medicaid pay for laboratory tests and imaging?
Pennsylvania Medicaid publishes 1,500 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 Pennsylvania's lab & imaging rates compare with Medicare?
Across lab & imaging codes with a national Medicare comparator, Pennsylvania 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 Pennsylvania?
Pennsylvania 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 Pennsylvania'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.