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Billing code 75956 · Radiology

75956 Medicaid reimbursement rate by state (2026)

Imaging and radiology. Medicaid pays a median of $318.78 for 75956 across 12 states, from $208.53 in Michigan to $2,013.14 in Arizona.

Data as of Oct 5, 202612 statesEvery rate links to its official source

States publishing
12
National median
$318.78units vary by state
Lowest
$208.53Michigan
Highest
$2,013.14Arizona
Answer

What does Medicaid pay for 75956?

12 state Medicaid programs publish a fee-for-service rate for 75956. The national median is $318.78 (units differ between states). Arizona pays the most, $2,013.14, and Michigan the least, $208.53, a 9.7x spread.

State ranking

75956 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 12 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Arizona Source · since 2024-10-01$2,013.14——Plans negotiate; applies out of network—
2Arkansas Source · since 2025-06-13$493.21——Not classified—
3New Mexico Source · since 2023-07-01$400.84——Plans must pay at least this—
6Colorado Source · since 2024-07-01$342.84——Plans negotiate; applies out of network—
7Kentucky Source · since 2022-01-01$294.71——Plans negotiate; applies out of network—
8Massachusetts Source · since 2026-10-01$236.95——Plans negotiate; applies out of network—
11Rhode Island Source · since 2006-01-01$214.66——Plans negotiate; applies out of network—
12Michigan Source · since 2025-01-01$208.53——Plans negotiate; applies out of network—
See all 12 states for 75956 — start free

4 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

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Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track 75956 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
Guide

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 75956, 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. 7 of the 12 states list more than one rate for 75956, 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. None of the 12 schedules prints a separate unit for 75956, so each amount is a flat payment for one service as the code defines it.
  • Per hour. 75956 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. No Medicare physician fee schedule amount is on file for 75956, so there is no percentage.
  • Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Context

Why 75956 rates differ between states

Published rates for 75956 run from $208.53 in Michigan to $2,013.14 in Arizona, a 9.7x gap in the same unit. Half the states pay more than the median of $318.78 and half pay less. The usual reasons for a spread like this in radiology rates:

  • 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.
  • States that benchmark imaging to Medicare use different percentages and different Medicare years.
  • Advanced imaging such as CT, MRI and PET is often under separate pricing and prior-authorization policies that vary from state to state.

Timing matters too. 1 state set the current rate for 75956 in 2026 or later, while 5 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.

Managed care

What managed-care plans pay for 75956

What a plan pays for 75956 is negotiated privately, but the state decides how much room there is to negotiate. Here is how the rules break down across the 12 states.

In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 9 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 1 state is not classified yet.

  • Plans negotiate; the published rate applies out of network (9 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 (2 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.

Billing

Units and billing for 75956

75956 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.

Contrast agents and radiopharmaceuticals are usually billed separately under their own codes. 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.

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.

FAQ

Frequently asked questions

What does Medicaid pay for 75956?

It depends on the state. Of the 12 states with a published fee-for-service rate, the median is $318.78. Arizona pays the most ($2,013.14) and Michigan the least ($208.53).

Which state pays the highest Medicaid rate for 75956?

Arizona, at $2,013.14, effective 2024-10-01.

Which state pays the lowest Medicaid rate for 75956?

Michigan, at $208.53, effective 2025-01-01.

What unit is 75956 billed in?

None of the 12 schedules prints a separate unit for 75956, so each amount is a flat payment for one service as the code defines it.

Do managed-care plans pay the same rate for 75956?

Not necessarily. In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 9 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 1 state is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.