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0237U Medicaid reimbursement rates by state

Clinical lab tests. 10 state Medicaid programs publish a fee-for-service rate for 0237U at the independent level. Rates run from $315.85 in Florida to $584.90 in Arizona, with a median of $584.90.

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

States publishing
10
Median rate
$584.90units vary by state
Highest
$584.90Arizona
Medicare (non-facility)
—not on the physician fee schedule

0237U 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
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$584.90since 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)$584.90since 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)$584.90since 2024-07-01unit—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)$584.90since 2022-01-01——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)$584.90since 2024-11-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
MontanaIndependent (non-agency) provider · Montana Medicaid and HMK Plus (fee-for-service)$584.89since 2022-01-01——Not classified—Montana Healthcare Programs fee schedule
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$526.41since 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)$526.41since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$465.00since 2026-02-01——Not classified—Maryland Medicaid Medical Laboratory Fee
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$315.85since 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 0237U?

It depends on the state. Of the 10 states with a published fee-for-service rate, the median is $584.90. Arizona pays the most ($584.90) and Florida the least ($315.85).

Which state pays the highest Medicaid rate for 0237U?

Arizona, at $584.90, effective 2026-10-01.

Do managed-care plans pay the same rate for 0237U?

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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