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0011U Medicaid reimbursement rates by state

Clinical lab tests. 6 state Medicaid programs publish a fee-for-service rate for 0011U at the clinical nurse specialist level. Rates run from $28.61 in Kansas to $114.43 in Kentucky, with a median of $82.39.

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

States publishing
6
Median rate
$82.39units vary by state
Highest
$114.43Kentucky
Medicare (non-facility)
—not on the physician fee schedule

0011U 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
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$114.43since 2020-01-01——Plans negotiate; applies out of network—KY Medicaid Clinical Lab fee schedule (2
ArizonaClinical nurse specialist · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$102.99since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Clinical
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$102.99since 2026-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Independent L
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$61.79since 2026-01-01——Plans negotiate; applies out of network—Independent Laboratory Fee Schedule (202
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$57.22since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$28.61since 2019-01-01——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 0011U?

It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $82.39. Kentucky pays the most ($114.43) and Kansas the least ($28.61).

Which state pays the highest Medicaid rate for 0011U?

Kentucky, at $114.43, effective 2020-01-01.

Do managed-care plans pay the same rate for 0011U?

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 Lab & pathology codes

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Medicaid rates by state