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0253U Medicaid reimbursement rates by state

Clinical lab tests. 5 state Medicaid programs publish a fee-for-service rate for 0253U. Rates run from $1,706.09 in Florida to $3,159.42 in Kentucky, with a median of $2,843.48.

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

States publishing
5
Median rate
$2,843.48units vary by state
Highest
$3,159.42Kentucky
Medicare (non-facility)
—not on the physician fee schedule

0253U 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
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$3,159.42since 2023-01-01——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)$3,159.42since 2024-11-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$2,843.48since 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)$2,843.48since 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)$1,706.09since 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 0253U?

It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $2,843.48. Kentucky pays the most ($3,159.42) and Florida the least ($1,706.09).

Which state pays the highest Medicaid rate for 0253U?

Kentucky, at $3,159.42, effective 2023-01-01.

Do managed-care plans pay the same rate for 0253U?

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 0253U in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
Medicaid rates by state