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0365U Medicaid reimbursement rates by state

Clinical lab tests. 5 state Medicaid programs publish a fee-for-service rate for 0365U. Rates run from $484.38 in Florida to $897.00 in Kentucky, with a median of $807.30.

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

States publishing
5
Median rate
$807.30units vary by state
Highest
$897.00Kentucky
Medicare (non-facility)
—not on the physician fee schedule

0365U 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)$897.00since 2024-01-01——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)$807.30since 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)$807.30since 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)$713.12since 2026-02-01——Not classified—Maryland Medicaid Medical Laboratory Fee
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$484.38since 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 0365U?

It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $807.30. Kentucky pays the most ($897.00) and Florida the least ($484.38).

Which state pays the highest Medicaid rate for 0365U?

Kentucky, at $897.00, effective 2024-01-01.

Do managed-care plans pay the same rate for 0365U?

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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