74019 Medicaid reimbursement rate by state (2026)
Imaging and radiology. Medicaid pays a median of $21.02 for 74019 across 50 states, from $6.81 in Rhode Island to $40.21 in Arizona.
- States publishing
- 50
- National median
- $21.02units vary by state
- Lowest
- $6.81Rhode Island
- Highest
- $40.21Arizona
What does Medicaid pay for 74019?
50 state Medicaid programs publish a fee-for-service rate for 74019. The national median is $21.02 (units differ between states). Arizona pays the most, $40.21, and Rhode Island the least, $6.81, a 5.9x spread.
Medicare (non-facility, 2026 physician fee schedule): $31.79–$48.97 depending on the state's Medicare locality.
74019 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 50 states with every variant, modifier and effective date.
How to read this table
- Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for 74019, so the order is by published amount and is not a like-for-like rank.
- Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 45 of the 50 states list more than one rate for 74019, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
- Unit. Of the 50 states, 2 publish 74019 per unit, and 48 schedules print no unit at all (a flat amount per service).
- Per hour. 74019 is not billed in time units in these states, so no hourly figure is shown.
- Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
- % of Medicare. Medicare amounts exist for 74019, but no state's Medicaid unit matches Medicare's billing unit closely enough to compute a percentage.
- Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Why 74019 rates differ between states
Published rates for 74019 run from $6.81 in Rhode Island to $40.21 in Arizona, a 5.9x gap in the same unit. Half the states pay more than the median of $21.02 and half pay less. The usual reasons for a spread like this in radiology rates:
- Advanced imaging such as CT, MRI and PET is often under separate pricing and prior-authorization policies that vary from state to state.
- Imaging fees are split into a professional component (the reading) and a technical component (the equipment and staff), and states publish one, the other or a global amount.
- Some states pay hospitals for the technical component through an outpatient system and pay only the professional component from the physician schedule.
Timing matters too. 29 states set the current rate for 74019 in 2026 or later, while 11 states still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.
What managed-care plans pay for 74019
What a plan pays for 74019 is negotiated privately, but the state decides how much room there is to negotiate. Here is how the rules break down across the 50 states.
In 8 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 28 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 14 states is not classified yet.
- Plans negotiate; the published rate applies out of network (28 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.
- Plans must pay at least the published rate (8 states). The published rate is your floor. Negotiate up from it, and if a plan pays less, the contract provision is the basis for a payment dispute.
Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example Arizona managed care.
Units and billing for 74019
74019 is a CPT radiology code in the radiology line, billed mostly by radiology groups, imaging centers and hospitals. Imaging codes are paid per study and split into a professional component (the reading, modifier 26) and a technical component (the equipment and staff, modifier TC). A global amount covers both.
Imaging is billed per study, with modifier 26 for the professional component and TC for the technical component; a claim without either is paid at the global amount where the state publishes one. Contrast agents and radiopharmaceuticals are usually billed separately under their own codes.
Medicare's 2026 physician fee schedule pays $31.79–$48.97 for 74019 (non-facility), depending on the Medicare locality. That is a useful reference point, but Medicare and Medicaid can define the unit differently, so compare only where the units match.
Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.
Frequently asked questions
What does Medicaid pay for 74019?
It depends on the state. Of the 50 states with a published fee-for-service rate, the median is $21.02. Arizona pays the most ($40.21) and Rhode Island the least ($6.81).
Which state pays the highest Medicaid rate for 74019?
Arizona, at $40.21, effective 2024-10-01.
Which state pays the lowest Medicaid rate for 74019?
Rhode Island, at $6.81, effective 2018-01-01.
What unit is 74019 billed in?
Of the 50 states, 2 publish 74019 per unit, and 48 schedules print no unit at all (a flat amount per service).
Do managed-care plans pay the same rate for 74019?
Not necessarily. In 8 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 28 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 14 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.