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Billing code 0407U · Lab & pathology

0407U Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $893.00 for 0407U across 8 states, from $513.00 in Florida to $950.00 in Kentucky.

Data as of Oct 5, 20268 statesEvery rate links to its official source

States publishing
8
National median
$893.00units vary by state
Lowest
$513.00Florida
Highest
$950.00Kentucky
Answer

What does Medicaid pay for 0407U?

8 state Medicaid programs publish a fee-for-service rate for 0407U. The national median is $893.00 (units differ between states). Kentucky pays the most, $950.00, and Florida the least, $513.00, a 1.9x spread.

State ranking

0407U rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 8 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Kentucky Source · since 2025-01-01$950.00——Plans negotiate; applies out of network—
2Hawaii Source · since 2026-06-01$950.00——Plans negotiate; applies out of network—
3Montana Source · since 2024-01-01$949.99——Not classified—
7Maryland Source · since 2026-02-01$604.20——Not classified—
8Florida Source · since 2026-01-01$513.00——Plans negotiate; applies out of network—
See all 8 states for 0407U — start free

3 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

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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; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track 0407U in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
FAQ

Frequently asked questions

What does Medicaid pay for 0407U?

It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $893.00. Kentucky pays the most ($950.00) and Florida the least ($513.00).

Which state pays the highest Medicaid rate for 0407U?

Kentucky, at $950.00, effective 2025-01-01.

Do managed-care plans pay the same rate for 0407U?

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 workspace shows the rule for each state, cited to the contract or statute.