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0563U Medicaid reimbursement rates by state

Clinical lab tests. 7 state Medicaid programs publish a fee-for-service rate for 0563U. Rates run from $312.59 in Ohio to $416.78 in Arizona, with a median of $333.42.

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

States publishing
7
Median rate
$333.42units vary by state
Highest
$416.78Arizona
Medicare (non-facility)
—not on the physician fee schedule

0563U 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
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$416.78since 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)$416.78since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$375.10since 2026-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Independent L
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$333.42since 2026-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$333.42since 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)$331.34since 2026-01-01——Not classified—Maryland Medicaid Medical Laboratory Fee
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$312.59since 2026-07-01——Plans negotiate; applies out of network—ODM CPT/HCPCS procedure code changes (Cl

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 0563U?

It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $333.42. Arizona pays the most ($416.78) and Ohio the least ($312.59).

Which state pays the highest Medicaid rate for 0563U?

Arizona, at $416.78, effective 2026-10-01.

Do managed-care plans pay the same rate for 0563U?

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.

Related Lab & pathology codes

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