G6009 Medicaid reimbursement rate by state (2026)
Radiation treatment delivery, 2 separate treatment areas. Medicaid pays a median of $153.26 for G6009 across 8 states, from $108.84 in Michigan to $171.56 in California.
- States publishing
- 8
- National median
- $153.26units vary by state
- Lowest
- $108.84Michigan
- Highest
- $171.56California
What does Medicaid pay for G6009?
8 state Medicaid programs publish a fee-for-service rate for G6009. The national median is $153.26 (units differ between states). California pays the most, $171.56, and Michigan the least, $108.84, a 1.6x spread.
G6009 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 8 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 G6009, 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. 3 of the 8 states list more than one rate for G6009, 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 8 states, 1 publish G6009 per unit, and 7 schedules print no unit at all (a flat amount per service).
- Per hour. G6009 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 G6009, 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 G6009 rates differ between states
Published rates for G6009 run from $108.84 in Michigan to $171.56 in California, a 1.6x gap in the same unit. Half the states pay more than the median of $153.26 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.
- 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.
Timing matters too. 1 state set the current rate for G6009 in 2026 or later, while 4 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 G6009
No managed-care plan publishes what it pays for G6009. What is public is the rule each state's plan contracts set, and that rule decides how much the published rate matters when you contract with a plan.
In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 6 states, plans negotiate and the published rate is a benchmark or out-of-network default.
- Plans negotiate; the published rate applies out of network (6 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 California managed care.
Units and billing for G6009
G6009 is a HCPCS Level II professional services code in the radiology line, billed mostly by radiology groups, imaging centers and hospitals. G codes describe professional services and procedures that have no CPT code, or that payers define more narrowly. Many are timed, so check the unit before comparing.
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 G6009?
It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $153.26. California pays the most ($171.56) and Michigan the least ($108.84).
Which state pays the highest Medicaid rate for G6009?
California, at $171.56, effective 2022-01-01.
Which state pays the lowest Medicaid rate for G6009?
Michigan, at $108.84, effective 2025-01-01.
What unit is G6009 billed in?
Of the 8 states, 1 publish G6009 per unit, and 7 schedules print no unit at all (a flat amount per service).
Do managed-care plans pay the same rate for G6009?
Not necessarily. In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 6 states, plans negotiate and the published rate is a benchmark or out-of-network default. Each rule is cited to the plan contract, statute or notice in the workspace.