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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.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
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.

Related Lab & pathology codes

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