0216U Medicaid reimbursement rates by state
Clinical lab tests. 7 state Medicaid programs publish a fee-for-service rate for 0216U. Rates run from $829.99 in Florida to $1,537.02 in Arizona, with a median of $1,537.02.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 7
- Median rate
- $1,537.02units vary by state
- Highest
- $1,537.02Arizona
- Medicare (non-facility)
- —not on the physician fee schedule
0216U 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 |
|---|---|---|---|---|---|---|
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $1,537.02since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Clinical |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $1,537.02since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $1,537.02since 2024-07-01 | unit | — | 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) | $1,537.02since 2022-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Clinical Lab fee schedule (2 |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $1,383.32since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | MO HealthNet fee schedule: Independent L |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $1,152.77since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | ODM CPT/HCPCS procedure code changes (Cl |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $829.99since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Independent Laboratory Fee Schedule (202 |
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 0216U?
It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $1,537.02. Arizona pays the most ($1,537.02) and Florida the least ($829.99).
Which state pays the highest Medicaid rate for 0216U?
Arizona, at $1,537.02, effective 2026-10-01.
Do managed-care plans pay the same rate for 0216U?
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.