Skip to content
Billing code 79445 · Radiology

79445 Medicaid reimbursement rate by state (2026)

Imaging and radiology. Medicaid pays a median of $100.60 for 79445 across 46 states, from $58.33 in New Jersey to $565.68 in Montana.

Data as of Oct 5, 202646 statesEvery rate links to its official source

States publishing
46
National median
$100.60units vary by state
Lowest
$58.33New Jersey
Highest
$565.68Montana
Answer

What does Medicaid pay for 79445?

46 state Medicaid programs publish a fee-for-service rate for 79445. The national median is $100.60 (units differ between states). Montana pays the most, $565.68, and New Jersey the least, $58.33, a 9.7x spread.

State ranking

79445 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 46 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Montana Source · since 2025-07-01$565.68——Not classified—
2Florida Source · since 2026-01-01$299.62——Plans negotiate; applies out of network—
3New Hampshire Source · since 2025-01-01$251.34——Plans negotiate; applies out of network—
23Wisconsin Source · since 2008-07-01$100.84——Plans negotiate; applies out of network—
24North Carolina Source · since 2025-10-01$100.35——Plans must pay at least this—
25Oklahoma Source · since 2026-07-01$96.06——Plans must pay at least this—
45Washington Source · since 2026-07-01$62.49——Plans negotiate; applies out of network—
46New Jersey Source · since 2025-01-01$58.33——Not classified—
See all 46 states for 79445 — start free

38 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.

  • Source for every rate
  • Full rate history
  • CSV and API export

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 79445 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 79445, 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. 36 of the 46 states list more than one rate for 79445, 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 46 states, 1 publish 79445 per unit, and 45 schedules print no unit at all (a flat amount per service).
  • Per hour. 79445 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 79445, 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 79445 rates differ between states

Published rates for 79445 run from $58.33 in New Jersey to $565.68 in Montana, a 9.7x gap in the same unit. Half the states pay more than the median of $100.60 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.
  • States that benchmark imaging to Medicare use different percentages and different Medicare years.
  • 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. 24 states set the current rate for 79445 in 2026 or later, while 10 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 79445

Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For 79445, the public signal is the rule each state sets for its plans, recorded on each rate above.

In 9 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 21 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 16 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (21 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 (9 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 Montana managed care.

Billing

Units and billing for 79445

79445 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 79445?

It depends on the state. Of the 46 states with a published fee-for-service rate, the median is $100.60. Montana pays the most ($565.68) and New Jersey the least ($58.33).

Which state pays the highest Medicaid rate for 79445?

Montana, at $565.68, effective 2025-07-01.

Which state pays the lowest Medicaid rate for 79445?

New Jersey, at $58.33, effective 2025-01-01.

What unit is 79445 billed in?

Of the 46 states, 1 publish 79445 per unit, and 45 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for 79445?

Not necessarily. In 9 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 21 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 16 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.