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0016U Medicaid reimbursement rates by state

Clinical lab tests. 14 state Medicaid programs publish a fee-for-service rate for 0016U at the physician psychologist level. Rates run from $40.99 in Kansas to $163.96 in Montana, with a median of $147.56.

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

States publishing
14
Median rate
$147.56units vary by state
Highest
$163.96Montana
Medicare (non-facility)
—not on the physician fee schedule

0016U 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
MontanaIndependent (non-agency) provider · Montana Medicaid and HMK Plus (fee-for-service)$163.96since 2021-07-01——Not classified—Montana Healthcare Programs fee schedule
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$163.96since 2024-07-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$163.96since 2020-01-01——Plans negotiate; applies out of network—KY Medicaid Clinical Lab fee schedule (2
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$163.96since 2024-11-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$163.96since 2026-06-01——Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$157.32since 2022-05-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
ArizonaClinical nurse specialist · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$147.56since 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)$147.56since 2026-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Independent L
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$147.56since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$145.84since 2024-01-01——Plans must pay at least this—SoonerCare Title XIX Fee Schedule
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$131.17since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$88.54since 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)$81.98since 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$40.99since 2021-01-01——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 0016U?

It depends on the state. Of the 14 states with a published fee-for-service rate, the median is $147.56. Montana pays the most ($163.96) and Kansas the least ($40.99).

Which state pays the highest Medicaid rate for 0016U?

Montana, at $163.96, effective 2021-07-01.

Do managed-care plans pay the same rate for 0016U?

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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