A9504 Medicaid reimbursement rates by state
Technetium tc-99m apcitide, diagnostic, per study dose. 12 state Medicaid programs publish a fee-for-service rate for A9504 at the physician psychologist level. Rates run from $5.00 in Kansas to $563.72 in South Dakota, with a median of $390.00.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 12
- Median rate
- $390.00units vary by state
- Highest
- $563.72South Dakota
- Medicare (non-facility)
- —not on the physician fee schedule
A9504 rate in every state
One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $563.72since 2026-07-01 | — | — | Not classified | — | South Dakota Medicaid Drugs and Biologic |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $475.00since 2021-01-01 | — | — | Plans negotiate; applies out of network | — | HCA Physician-related services fee sched |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $475.00since 2004-01-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $473.71since 2013-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $457.24since 2020-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| ArkansasPhysician or licensed psychologist (incl. BCBA-D) · Arkansas Medicaid (fee-for-service) | $400.00since 2025-06-13 | — | — | Not classified | — | Arkansas Medicaid Physician / CRNA / Fam |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $380.00since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $372.77since 2014-01-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $355.95since 2008-01-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $90.00since 2017-11-10 | percent of billed charges | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $25.78since 2024-01-01 | — | — | Plans must pay at least this | — | Provider Type 20 Physician, MD., Osteopa |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $5.00since 2000-01-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
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 with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.
Frequently asked questions
What does Medicaid pay for A9504?
It depends on the state. Of the 12 states with a published fee-for-service rate, the median is $390.00. South Dakota pays the most ($563.72) and Kansas the least ($5.00).
Which state pays the highest Medicaid rate for A9504?
South Dakota, at $563.72, effective 2026-07-01.
Do managed-care plans pay the same rate for A9504?
Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The table shows the rule for each state, cited to the contract or statute.