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0115U Medicaid reimbursement rates by state

Clinical lab tests. 8 state Medicaid programs publish a fee-for-service rate for 0115U at the independent level. Rates run from $68.84 in Kansas to $275.35 in Montana, with a median of $261.59.

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

States publishing
8
Median rate
$261.59units vary by state
Highest
$275.35Montana
Medicare (non-facility)
—not on the physician fee schedule

0115U 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)$275.35since 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)$275.35since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Clinical
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$275.35since 2021-01-01——Plans negotiate; applies out of network—KY Medicaid Clinical Lab fee schedule (2
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$275.35since 2026-06-01——Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$247.82since 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)$247.82since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$148.69since 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$68.84since 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 0115U?

It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $261.59. Montana pays the most ($275.35) and Kansas the least ($68.84).

Which state pays the highest Medicaid rate for 0115U?

Montana, at $275.35, effective 2021-07-01.

Do managed-care plans pay the same rate for 0115U?

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

Track 0115U in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
Medicaid rates by state