0047U Medicaid reimbursement rates by state
Clinical lab tests. 21 state Medicaid programs publish a fee-for-service rate for 0047U at the independent level. Rates run from $968.25 in Kansas to $3,873.00 in Montana, with a median of $3,444.98.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 21
- Median rate
- $3,444.98units vary by state
- Highest
- $3,873.00Montana
- Medicare (non-facility)
- —not on the physician fee schedule
0047U 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 |
|---|---|---|---|---|---|---|
| MontanaIndependent (non-agency) provider · Montana Medicaid and HMK Plus (fee-for-service) | $3,873.00since 2021-07-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $3,873.00since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Clinical |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $3,873.00since 2021-04-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $3,873.00since 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) | $3,873.00since 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 | $3,873.00since 2026-06-01 | — | — | Plans negotiate; applies out of network | — | Medicaid Fee-For-Service (FFS) Fee Sched |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service) | $3,873.00since 2022-07-01 | — | — | Plans negotiate; applies out of network | — | RI Medicaid Interactive Fee For Service |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $3,485.70since 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) | $3,485.70since 2026-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, Septembe |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $3,485.70since 2023-04-01 | — | — | Plans negotiate; applies out of network | — | BMS CY 2023 Clinical Lab Fee Schedule (a |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $3,444.98since 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) | $3,098.40since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $3,098.40since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | HCA Physician-related services fee sched |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $3,097.16since 2026-07-01 | — | — | Not classified | — | Clinical Diagnostic Laboratory Test (CDL |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $3,079.04since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Medical Laboratory Fee |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $2,904.75since 2021-01-01 | — | — | Plans negotiate; applies out of network | — | ODM laboratory services payment schedule |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $2,711.10since 2021-03-01 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $2,637.90since 2022-01-01 | — | — | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $2,091.42since 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) | $1,936.50since 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 | $968.25since 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 0047U?
It depends on the state. Of the 21 states with a published fee-for-service rate, the median is $3,444.98. Montana pays the most ($3,873.00) and Kansas the least ($968.25).
Which state pays the highest Medicaid rate for 0047U?
Montana, at $3,873.00, effective 2021-07-01.
Do managed-care plans pay the same rate for 0047U?
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.