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Billing code 0455U · Lab & pathology

0455U Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $134.08 for 0455U across 10 states, from $77.02 in Florida to $142.63 in Montana.

Data as of Oct 5, 202610 statesEvery rate links to its official source

States publishing
10
National median
$134.08units vary by state
Lowest
$77.02Florida
Highest
$142.63Montana
Answer

What does Medicaid pay for 0455U?

10 state Medicaid programs publish a fee-for-service rate for 0455U. The national median is $134.08 (units differ between states). Montana pays the most, $142.63, and Florida the least, $77.02, a 1.9x spread.

State ranking

0455U rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 10 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Montana Source · since 2025-01-01$142.63——Not classified—
2California Source · since 2026-10-01$142.63——Plans negotiate; applies out of network—
3Kentucky Source · since 2025-01-01$142.63——Plans negotiate; applies out of network—
5Delaware Source · since 2025-01-01$139.78——Plans negotiate; applies out of network—
6Missouri Source · since 2026-07-01$128.37——Plans negotiate; applies out of network—
9Maryland Source · since 2026-02-01$113.39——Not classified—
10Florida Source · since 2026-01-01$77.02——Plans negotiate; applies out of network—
See all 10 states for 0455U — 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 0455U 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 0455U?

It depends on the state. Of the 10 states with a published fee-for-service rate, the median is $134.08. Montana pays the most ($142.63) and Florida the least ($77.02).

Which state pays the highest Medicaid rate for 0455U?

Montana, at $142.63, effective 2025-01-01.

Do managed-care plans pay the same rate for 0455U?

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.