0686T Medicaid reimbursement rates by state
Outpatient hospital services (fee schedule). 5 state Medicaid programs publish a fee-for-service rate for 0686T. Rates run from $1,445.36 in Kansas to $17,500.50 in Connecticut, with a median of $8,932.05.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 5
- Median rate
- $8,932.05units vary by state
- Highest
- $17,500.50Connecticut
- Medicare (non-facility)
- —not on the physician fee schedule
0686T 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 |
|---|---|---|---|---|---|---|
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $17,500.50since 2026-01-01 | — | — | Not classified | — | CMAP Addendum B - OPPS Payment Type by P |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $9,177.92since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid ASC fee schedule (2026ASCFee |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $8,932.05since 2026-01-01 | — | — | Not classified | — | Arkansas Medicaid CY2026 Ambulatory Surg |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $5,144.40since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS Final Ambulatory Surgery Center R |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $1,445.36since 2022-01-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Amb Surgical Cente |
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 0686T?
It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $8,932.05. Connecticut pays the most ($17,500.50) and Kansas the least ($1,445.36).
Which state pays the highest Medicaid rate for 0686T?
Connecticut, at $17,500.50, effective 2026-01-01.
Do managed-care plans pay the same rate for 0686T?
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.