0427U Medicaid reimbursement rates by state
Clinical lab tests. 7 state Medicaid programs publish a fee-for-service rate for 0427U at the independent level. Rates run from $2.42 in Florida to $4.48 in Montana, with a median of $4.03.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 7
- Median rate
- $4.03units vary by state
- Highest
- $4.48Montana
- Medicare (non-facility)
- —not on the physician fee schedule
0427U 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 |
|---|---|---|---|---|---|---|
| MontanaIndependent (non-agency) provider · Montana Medicaid and HMK Plus (fee-for-service) | $4.48since 2025-01-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $4.48since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Clinical Lab fee schedule (2 |
| IowaIndependent (non-agency) provider · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $4.26since 2025-01-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #10 INDEPENDE |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $4.03since 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) | $4.03since 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) | $3.56since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Medical Laboratory Fee |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $2.42since 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 0427U?
It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $4.03. Montana pays the most ($4.48) and Florida the least ($2.42).
Which state pays the highest Medicaid rate for 0427U?
Montana, at $4.48, effective 2025-01-01.
Do managed-care plans pay the same rate for 0427U?
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.