Vermont Medicaid Lab & Imaging Fee Schedule 2026

Vermont Medicaid publishes 1,880 lab & imaging procedure rates effective 2026, paying a median 97.5% 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.

The Rates plan

$29/mo7-day free trial

The table on this page is a common-procedure sample. The full Vermont lab & imaging schedule has 1,880 codes.

  • Every code on all 51 published schedules
  • Full-schedule CSV export
  • Full state Medicaid dental network lists
  • Email alerts when a state changes its rates
Start 7-day free trial

$29/mo after the trial. Cancel anytime.

Published codes

1,880

Lab & Imaging procedures on the 2026 schedule

Median % of Medicare

97.5%

vs national Medicare, GPCI-neutral

PA required

71

codes flagged by the state

Common lab & imaging procedures and what Vermont Medicaid pays

A curated sample of recognizable procedures from the 1,880-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.

CodeProcedureVermont rate% of Medicare
70110Jaw (mandible) X-ray, 4 or more views$36.2384.1%
70140Facial bone X-ray, under 3 views$26.6183.9%
70160Nasal bone X-ray$31.4384%
70220Sinus X-ray, 3 or more views$31.7184%
70360Neck soft tissue X-ray$26.0483.8%
70450CT scan of the head without contrast$89.4483.9%
70480CT scan of the eye socket or inner ear without contrast$132.8983.9%
70486CT scan of the face and sinuses without contrast$107.8584.1%
70491CT scan of neck soft tissue with contrast$154.4084.2%
70551MRI of the brain without contrast$164.1784%
70553MRI of the brain without then with contrast$266.3684%
71045Chest X-ray, 1 view$21.2383.6%
71046Chest X-ray, 2 views$27.7483.9%
71047Chest X-ray, 3 views$34.5384.1%
71048Chest X-ray, 4 or more views$37.7983.8%
71100Rib X-ray, one side$30.2984%
71250CT scan of the chest without contrast$111.3884%
71260CT scan of the chest with contrast$139.9884%
71275CT angiography of the chest$236.0884.1%
72040Neck (cervical) spine X-ray, 2-3 views$33.4084%
72070Mid-back (thoracic) spine X-ray, 2 views$27.7483.9%
72100Lower back (lumbar) spine X-ray, 2-3 views$33.6983.4%
72110Lower back (lumbar) spine X-ray, 4 or more views$44.8784%
72125CT scan of the neck (cervical) spine without contrast$109.6884%
72131CT scan of the lower (lumbar) spine without contrast$109.1284%

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 Vermont Medicaid fee schedules

Lab & Imaging rates in neighboring states

Frequently asked questions

What does Vermont Medicaid pay for laboratory tests and imaging?

Vermont Medicaid publishes 1,880 lab & imaging procedure rates effective 2026, paying a median 97.5% 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 Vermont's lab & imaging rates compare with Medicare?

Across lab & imaging codes with a national Medicare comparator, Vermont Medicaid pays a median 97.5% 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 Vermont?

Vermont publishes prior-authorization flags on its schedule: 71 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 Vermont'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.

Get an email the next time Vermont changes these rates.