M0223 Medicaid reimbursement rates by state
Intravenous injection, bebtelovimab. 8 state Medicaid programs publish a fee-for-service rate for M0223. Rates run from $440.00 in Georgia to $561.51 in Colorado, with a median of $550.50.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 8
- Median rate
- $550.50units vary by state
- Highest
- $561.51Colorado
- Medicare (non-facility)
- —not on the physician fee schedule
M0223 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 |
|---|---|---|---|---|---|---|
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $561.51since 2022-07-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $557.44since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $550.50since 2022-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Physicia |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $550.50since 2022-02-11 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid ad hoc COVID-19 fee sc |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $550.50since 2022-02-11 | — | — | Not classified | — | NJMMIS Coronavirus Services procedure co |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $550.50since 2023-02-02 | — | — | Plans negotiate; applies out of network | — | KY Medicaid COVID Infusion fee schedule |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $440.40since 2022-02-11 | — | — | Plans negotiate; applies out of network | — | 52 Pa.B. 2924 Addition of Monoclonal Ant |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $440.00since 2022-04-01 | — | — | Plans negotiate; applies out of network | — | Copy of PADL- Appendix A Published Copy_ |
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 M0223?
It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $550.50. Colorado pays the most ($561.51) and Georgia the least ($440.00).
Which state pays the highest Medicaid rate for M0223?
Colorado, at $561.51, effective 2022-07-01.
Do managed-care plans pay the same rate for M0223?
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.