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