0537U Medicaid reimbursement rates by state
Clinical lab tests. 10 state Medicaid programs publish a fee-for-service rate for 0537U. Rates run from $373.75 in Kansas to $1,495.00 in Arizona, with a median of $1,270.75.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 10
- Median rate
- $1,270.75units vary by state
- Highest
- $1,495.00Arizona
- Medicare (non-facility)
- —not on the physician fee schedule
0537U 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 |
|---|---|---|---|---|---|---|
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $1,495.00since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Clinical |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $1,495.00since 2025-10-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $1,495.00since 2025-04-01 | — | — | 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) | $1,345.50since 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) | $1,345.50since 2026-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, Septembe |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $1,196.00since 2025-10-01 | — | — | Not classified | — | Clinical Diagnostic Laboratory Test (CDL |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $1,188.53since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Medical Laboratory Fee |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $1,121.25since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | ODM CPT/HCPCS procedure code changes (Cl |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $807.30since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Independent Laboratory Fee Schedule (202 |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $373.75since 2025-04-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
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 0537U?
It depends on the state. Of the 10 states with a published fee-for-service rate, the median is $1,270.75. Arizona pays the most ($1,495.00) and Kansas the least ($373.75).
Which state pays the highest Medicaid rate for 0537U?
Arizona, at $1,495.00, effective 2026-10-01.
Do managed-care plans pay the same rate for 0537U?
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.