A9572 Medicaid reimbursement rates by state
Indium in-111 pentetreotide, diagnostic, per study dose. 15 state Medicaid programs publish a fee-for-service rate for A9572 at the physician psychologist level. Rates run from $78.75 in Ohio to $5,160.10 in Wisconsin, with a median of $3,870.00.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 15
- Median rate
- $3,870.00units vary by state
- Highest
- $5,160.10Wisconsin
- Medicare (non-facility)
- —not on the physician fee schedule
A9572 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 |
|---|---|---|---|---|---|---|
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $5,160.10since 2008-07-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $4,974.79since 2022-07-01 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $4,411.80since 2025-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Physician-related services fee sched |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $4,411.80since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| MontanaIndependent (non-agency) provider · Montana Medicaid and HMK Plus (fee-for-service) | $4,411.80since 2021-01-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $4,411.80since 2025-07-01 | — | — | Not classified | — | South Dakota Medicaid Drugs and Biologic |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $4,133.16since 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) | $3,870.00since 2026-08-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Physicia |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $3,811.80since 2026-07-01 | — | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $3,030.07since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $2,490.43since 2013-02-01 | — | — | Plans must pay at least this | — | Louisiana Medicaid Professional Services |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $2,000.94since 2026-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, Septembe |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $724.95since 2024-01-01 | — | — | Plans must pay at least this | — | Provider Type 20 Physician, MD., Osteopa |
| ArkansasPhysician or licensed psychologist (incl. BCBA-D) · Arkansas Medicaid (fee-for-service) | $128.00since 2025-06-13 | — | — | Not classified | — | Arkansas Medicaid Physician / CRNA / Fam |
| 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 A9572?
It depends on the state. Of the 15 states with a published fee-for-service rate, the median is $3,870.00. Wisconsin pays the most ($5,160.10) and Ohio the least ($78.75).
Which state pays the highest Medicaid rate for A9572?
Wisconsin, at $5,160.10, effective 2008-07-01.
Do managed-care plans pay the same rate for A9572?
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.