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M0248 Medicaid reimbursement rates by state

Intravenous infusion, sotrovimab. 11 state Medicaid programs publish a fee-for-service rate for M0248 at the physician psychologist level. Rates run from $10.00 in Texas to $750.00 in Arizona, with a median of $750.00.

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

States publishing
11
Median rate
$750.00units vary by state
Highest
$750.00Arizona
Medicare (non-facility)
—not on the physician fee schedule

M0248 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)$750.00since 2021-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$750.00since 2021-05-26——Not classified—COVID-19 Payment Rates for Certain Commu
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$750.00since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Nurse Practiti
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$750.00since 2021-05-26——Not classified—NJMMIS Coronavirus Services procedure co
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$750.00since 2021-05-26——Not classified—COVID-19 Reimbursable Vaccine and Infusi
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$750.00since 2023-02-02——Plans negotiate; applies out of network—KY Medicaid COVID Infusion fee schedule
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$688.92since 2022-01-01——Plans negotiate; applies out of network—MDHHS COVID-19, January 2021
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$674.52since 2021-12-08——Plans negotiate; applies out of network—Nebraska Medicaid ad hoc COVID-19 fee sc
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$600.00since 2022-01-01——Plans negotiate; applies out of network—Copy of PADL- Appendix A Published Copy_
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$600.00since 2021-05-26——Plans negotiate; applies out of network—52 Pa.B. 1697 Updates to the Medical Ass
TexasAgency provider · Texas Home and Community-based Services (HCS) waiver (IDD)$10.00since 2024-09-01one time—Paid by the state, outside plans—HHSC PFD HCS payment rates (09-2024-hcs-

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 M0248?

It depends on the state. Of the 11 states with a published fee-for-service rate, the median is $750.00. Arizona pays the most ($750.00) and Texas the least ($10.00 per one time).

Which state pays the highest Medicaid rate for M0248?

Arizona, at $750.00, effective 2021-10-01.

Do managed-care plans pay the same rate for M0248?

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 Pharmacy codes

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