0413U Medicaid reimbursement rates by state
Clinical lab tests. 8 state Medicaid programs publish a fee-for-service rate for 0413U at the physician psychologist level. Rates run from $682.31 in Florida to $1,263.53 in Kentucky, with a median of $1,137.18.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 8
- Median rate
- $1,137.18units vary by state
- Highest
- $1,263.53Kentucky
- Medicare (non-facility)
- —not on the physician fee schedule
0413U 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 |
|---|---|---|---|---|---|---|
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $1,263.53since 2024-01-01 | — | — | 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) | $1,263.53since 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) | $1,263.52since 2024-01-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $1,137.18since 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) | $1,137.18since 2026-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, Septembe |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $1,137.18since 2024-04-01 | — | — | Plans negotiate; applies out of network | — | BMS CY 2024 Clinical Lab Fee Schedule |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $1,004.51since 2026-02-01 | — | — | Not classified | — | Maryland Medicaid Medical Laboratory Fee |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $682.31since 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 0413U?
It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $1,137.18. Kentucky pays the most ($1,263.53) and Florida the least ($682.31).
Which state pays the highest Medicaid rate for 0413U?
Kentucky, at $1,263.53, effective 2024-01-01.
Do managed-care plans pay the same rate for 0413U?
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.