0473U Medicaid reimbursement rates by state
Clinical lab tests. 11 state Medicaid programs publish a fee-for-service rate for 0473U. Rates run from $2,430.00 in Florida to $4,500.00 in California, with a median of $4,050.00.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 11
- Median rate
- $4,050.00units vary by state
- Highest
- $4,500.00California
- Medicare (non-facility)
- —not on the physician fee schedule
0473U 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 |
|---|---|---|---|---|---|---|
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $4,500.00since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $4,500.00since 2026-07-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $4,500.00since 2025-01-01 | — | — | 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) | $4,500.00since 2024-11-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service CPT |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $4,050.00since 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) | $4,050.00since 2026-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, Septembe |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $3,726.00since 2026-04-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Clinical Laboratory Fee Schedule, |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $3,600.00since 2026-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $3,577.50since 2026-02-01 | — | — | Not classified | — | Maryland Medicaid Medical Laboratory Fee |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $3,375.00since 2025-10-01 | — | — | Plans negotiate; applies out of network | — | ODM laboratory services payment schedule |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $2,430.00since 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 0473U?
It depends on the state. Of the 11 states with a published fee-for-service rate, the median is $4,050.00. California pays the most ($4,500.00) and Florida the least ($2,430.00).
Which state pays the highest Medicaid rate for 0473U?
California, at $4,500.00, effective 2026-10-01.
Do managed-care plans pay the same rate for 0473U?
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.