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A9516 Medicaid reimbursement rates by state

Iodine i-123 sodium iodide, diagnostic, per 100 microcuries. 12 state Medicaid programs publish a fee-for-service rate for A9516 at the physician psychologist level. Rates run from $22.87 in Colorado to $113.46 in Nebraska, with a median of $89.66.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
12
Median rate
$89.66units vary by state
Highest
$113.46Nebraska
Medicare (non-facility)
—not on the physician fee schedule

A9516 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.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$113.46since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$104.53since 2025-04-01——Plans negotiate; applies out of network—SCDHHS Nurse Midwives Fee Schedule (sche
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$103.47since 2026-01-01——Not classified—Maryland Medicaid Professional Services
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$95.84since 2024-07-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$95.62since 2026-08-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$89.98since 2024-02-01——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Physician Admi
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$89.33since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$88.16since 2013-07-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$70.86since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$65.02since 2026-08-25——Not classified—Physician Drug Fee Schedule (REF-0130-Q)
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$39.47since 2008-01-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$22.87since 2022-07-01——Not classified—Health First Colorado Physician Fee Sche

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 A9516?

It depends on the state. Of the 12 states with a published fee-for-service rate, the median is $89.66. Nebraska pays the most ($113.46) and Colorado the least ($22.87).

Which state pays the highest Medicaid rate for A9516?

Nebraska, at $113.46, effective 2026-07-01.

Do managed-care plans pay the same rate for A9516?

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.

Related Equipment & supplies codes

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