A9569 Medicaid reimbursement rates by state
Technetium tc-99m exametazime labeled autologous white blood.... 7 state Medicaid programs publish a fee-for-service rate for A9569. Rates run from $78.75 in Ohio to $1,953.92 in Washington, with a median of $1,655.65.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 7
- Median rate
- $1,655.65units vary by state
- Highest
- $1,953.92Washington
- Medicare (non-facility)
- —not on the physician fee schedule
A9569 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 |
|---|---|---|---|---|---|---|
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $1,953.92since 2024-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Physician-related services fee sched |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $1,851.09since 2024-02-01 | — | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Physician Admi |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $1,830.52since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $1,655.65since 2023-04-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Physicia |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $1,482.64since 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) | $1,138.00since 2012-05-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $78.75since 2008-01-01 | — | — | Plans negotiate; applies out of network | — | ODM provider-administered pharmaceutical |
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 A9569?
It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $1,655.65. Washington pays the most ($1,953.92) and Ohio the least ($78.75).
Which state pays the highest Medicaid rate for A9569?
Washington, at $1,953.92, effective 2024-07-01.
Do managed-care plans pay the same rate for A9569?
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.