G0480 Medicaid reimbursement rates by state
Drug test(s), definitive, utilizing. 28 state Medicaid programs publish a fee-for-service rate for G0480 at the physician psychologist level. Rates run from $15.15 in New York to $123.58 in Texas, with a median of $90.12.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 28
- Median rate
- $90.12units vary by state
- Highest
- $123.58Texas
- Medicare (non-facility)
- —not on the physician fee schedule
G0480 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 |
|---|---|---|---|---|---|---|
| TexasIndependent (non-agency) provider · Texas Medicaid (fee-for-service, TMHP) | $123.58since 2019-07-04 | day | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Labor |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $114.43since 2026-07-01 | day | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $114.43since 2024-01-01 | day | — | 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) | $114.43since 2018-01-01 | day | — | 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) | $114.43since 2020-01-01 | day | — | Plans negotiate; applies out of network | — | KY Medicaid Clinical Lab fee schedule (2 |
| ArizonaClinical nurse specialist · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $102.99since 2026-10-01 | day | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Clinical |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $102.99since 2026-07-01 | day | — | Plans negotiate; applies out of network | — | MO HealthNet fee schedule: Independent L |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $97.27since 2025-07-01 | day | — | Plans must pay at least this | — | Louisiana Medicaid Laboratory and Radiol |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $95.32since 2026-07-01 | day | — | Not classified | — | Clinical Diagnostic Laboratory Test (CDL |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $94.75since 2023-01-01 | day | — | Plans negotiate; applies out of network | — | MDHHS Child and Adolescent Health Center |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $94.12since 2018-10-01 | day | — | Plans negotiate; applies out of network | — | Lab Max Allowable (in Zipped 2018 Fee Sc |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $91.54since 2024-10-01 | day | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $91.54since 2021-12-01 | day | — | Plans must pay at least this | — | NJMMIS Procedure Master Listing Outpatie |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Public Behavioral Health System (specialty mental health, SUD and ABA, paid fee-for-service through the Carelon ASO) | $90.97since 2024-07-01 | Per test | — | Paid by the state, outside plans | — | FY2025 PBHS Fee Schedule – SUD_7.1.2024 |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $89.26since 2024-07-01 | day | — | Not classified | — | SCDHHS Independent Lab and Radiology Fee |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $85.82since 2021-01-01 | day | — | Plans negotiate; applies out of network | — | ODM laboratory services payment schedule |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $80.96since 2026-01-01 | day | — | Plans negotiate; applies out of network | — | HCA Physician-related services fee sched |
| AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $80.10since 2026-04-10 | day | — | Not classified | — | Laboratory and Radiology Fee Schedule (R |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $79.74since 2016-01-01 | day | — | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $77.94since 2024-04-01 | day | — | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $76.70since 2016-01-01 | day | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $72.75since 2025-10-01 | day | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Laboratory' - |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $63.95since 2026-10-01 | day | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $63.95since 2016-07-01 | day | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $63.95since 2016-01-01 | day | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $59.69since 2024-09-01 | day | — | Plans negotiate; applies out of network | — | Rates for Clinical Laboratory Services ( |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $24.78since 2016-01-01 | day | — | Not classified | — | CMAP fee schedule: Lab October 2026 |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $15.15since 2020-05-29 | day | — | Plans negotiate; applies out of network | — | eMedNY NYS Medicaid Laboratory Fee Sched |
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 G0480?
It depends on the state. Of the 28 states with a published fee-for-service rate, the median is $90.12. Texas pays the most ($123.58 per day) and New York the least ($15.15 per day).
Which state pays the highest Medicaid rate for G0480?
Texas, at $123.58 per day, effective 2019-07-04.
Do managed-care plans pay the same rate for G0480?
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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Track G0480 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.