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0493U Medicaid reimbursement rates by state

Clinical lab tests. 16 state Medicaid programs publish a fee-for-service rate for 0493U at the independent level. Rates run from $1,486.76 in Florida to $2,753.25 in Montana, with a median of $2,477.93.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
16
Median rate
$2,477.93units vary by state
Highest
$2,753.25Montana
Medicare (non-facility)
—not on the physician fee schedule

0493U 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.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
MontanaIndependent (non-agency) provider · Montana Medicaid and HMK Plus (fee-for-service)$2,753.25since 2025-01-01——Not classified—Montana Healthcare Programs fee schedule
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$2,753.25since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Clinical
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$2,753.25since 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)$2,753.25since 2026-01-12unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$2,753.25since 2025-10-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$2,753.25since 2025-01-01——Plans negotiate; applies out of network—KY Medicaid Clinical Lab fee schedule (2
TexasIndependent (non-agency) provider · Texas Medicaid (fee-for-service, TMHP)$2,497.74since 2019-07-04——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Labor
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$2,477.93since 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)$2,477.93since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$2,448.98since 2026-07-01——Plans must pay at least this—SoonerCare Title XIX Fee Schedule
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$2,202.60since 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)$2,188.83since 2026-02-01——Not classified—Maryland Medicaid Medical Laboratory Fee
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$2,064.94since 2025-10-01——Plans negotiate; applies out of network—ODM laboratory services payment schedule
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$1,927.28since 2025-05-01——Not classified—MaineCare Fee Schedule (MaineCare UCR, H
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$1,875.24since 2025-01-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$1,486.76since 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 0493U?

It depends on the state. Of the 16 states with a published fee-for-service rate, the median is $2,477.93. Montana pays the most ($2,753.25) and Florida the least ($1,486.76).

Which state pays the highest Medicaid rate for 0493U?

Montana, at $2,753.25, effective 2025-01-01.

Do managed-care plans pay the same rate for 0493U?

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.

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