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0023U Medicaid reimbursement rates by state

Clinical lab tests. 13 state Medicaid programs publish a fee-for-service rate for 0023U at the independent level. Rates run from $62.13 in Kansas to $248.51 in Kentucky, with a median of $223.66.

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

States publishing
13
Median rate
$223.66units vary by state
Highest
$248.51Kentucky
Medicare (non-facility)
—not on the physician fee schedule

0023U 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)$248.51since 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)$248.51since 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$248.51since 2026-06-01——Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched
MontanaIndependent (non-agency) provider · Montana Medicaid and HMK Plus (fee-for-service)$248.50since 2021-07-01——Not classified—Montana Healthcare Programs fee schedule
ArizonaClinical nurse specialist · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$223.66since 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)$223.66since 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)$223.66since 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)$221.05since 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)$198.81since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$198.81since 2026-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$197.57since 2026-02-01——Not classified—Maryland Medicaid Medical Laboratory Fee
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$134.20since 2026-01-01——Plans negotiate; applies out of network—Independent Laboratory Fee Schedule (202
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$62.13since 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 0023U?

It depends on the state. Of the 13 states with a published fee-for-service rate, the median is $223.66. Kentucky pays the most ($248.51) and Kansas the least ($62.13).

Which state pays the highest Medicaid rate for 0023U?

Kentucky, at $248.51, effective 2020-01-01.

Do managed-care plans pay the same rate for 0023U?

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.

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