G0481 Medicaid reimbursement rates by state
Drug test(s), definitive, utilizing. 43 state Medicaid programs publish a fee-for-service rate for G0481 at the physician psychologist level. Rates run from $10.00 in Kansas to $234.89 in New Mexico, with a median of $128.79.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 43
- Median rate
- $128.79units vary by state
- Highest
- $234.89New Mexico
- Medicare (non-facility)
- —not on the physician fee schedule
G0481 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 |
|---|---|---|---|---|---|---|
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $234.89since 2025-01-01 | day | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| TexasIndependent (non-agency) provider · Texas Medicaid (fee-for-service, TMHP) | $169.11since 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) | $156.59since 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) | $156.59since 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) | $156.59since 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) | $156.59since 2020-01-01 | day | — | Plans negotiate; applies out of network | — | KY Medicaid Clinical Lab fee schedule (2 |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service | $156.59since 2026-06-01 | day | — | Plans negotiate; applies out of network | — | Medicaid Fee-For-Service (FFS) Fee Sched |
| AlaskaPhysician or licensed psychologist (incl. BCBA-D) · Alaska Medicaid (fee-for-service, Department of Health) | $156.59since 2026-07-01 | day | — | Not classified | — | Alaska Medicaid Independent Laboratory F |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $156.59since 2021-01-01 | day | — | Not classified | — | South Dakota Medicaid Laboratory fee sch |
| MontanaIndependent (non-agency) provider · Montana Medicaid and HMK Plus (fee-for-service) | $156.58since 2025-04-01 | day | — | Not classified | — | Montana Healthcare Programs fee schedule |
| DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP) | $153.46since 2024-01-01 | day | — | Plans negotiate; applies out of network | — | DMAP 2024 Physician Fee Schedule |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $152.68since 2025-01-01 | day | — | Not classified | — | Vermont Medicaid Fee Schedule - HCPCS (i |
| ArizonaClinical nurse specialist · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $140.93since 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) | $140.93since 2026-07-01 | day | — | 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) | $140.93since 2022-07-01 | day | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, May 2023 |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $140.93since 2023-04-01 | day | — | Plans negotiate; applies out of network | — | BMS CY 2023 Clinical Lab Fee Schedule (a |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $139.28since 2024-01-01 | day | — | Plans must pay at least this | — | SoonerCare Title XIX Fee Schedule |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $135.29since 2025-09-01 | day | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $133.10since 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) | $130.44since 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) | $129.66since 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) | $128.79since 2018-10-01 | day | — | Plans negotiate; applies out of network | — | Lab Max Allowable (in Zipped 2018 Fee Sc |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $125.27since 2023-12-01 | day | — | Plans must pay at least this | — | NJMMIS Procedure Master Listing Outpatie |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $125.27since 2024-10-01 | day | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| 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) | $124.49since 2024-07-01 | Per test | — | Paid by the state, outside plans | — | FY2025 PBHS Fee Schedule – SUD_7.1.2024 |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $122.99since 2016-01-01 | day | — | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $122.68since 2024-01-01 | day | — | Plans must pay at least this | — | Provider Type 20 Physician, MD., Osteopa |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $118.00since 2016-01-01 | day | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $117.44since 2021-01-01 | day | — | Plans negotiate; applies out of network | — | ODM laboratory services payment schedule |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $112.69since 2017-01-01 | day | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $111.92since 2025-10-01 | day | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Laboratory' - |
| AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $109.61since 2026-04-10 | day | — | Not classified | — | Laboratory and Radiology Fee Schedule (R |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $106.65since 2024-04-01 | day | — | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $99.25since 2016-01-01 | day | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $98.39since 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) | $98.39since 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) | $98.39since 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) | $91.84since 2024-09-01 | day | — | Plans negotiate; applies out of network | — | Rates for Clinical Laboratory Services ( |
| 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 |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $80.79since 2023-07-01 | day | — | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service) | $73.79since 2016-01-01 | day | — | Plans negotiate; applies out of network | — | RI Medicaid Interactive Fee For Service |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $38.13since 2016-01-01 | day | — | Not classified | — | CMAP fee schedule: Lab October 2026 |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $10.00since 2016-01-01 | day | — | 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 G0481?
It depends on the state. Of the 43 states with a published fee-for-service rate, the median is $128.79. New Mexico pays the most ($234.89 per day) and Kansas the least ($10.00 per day).
Which state pays the highest Medicaid rate for G0481?
New Mexico, at $234.89 per day, effective 2025-01-01.
Do managed-care plans pay the same rate for G0481?
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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