U0005 Medicaid reimbursement rates by state
Infectious agent detection by nucleic acid (dna or rna). 8 state Medicaid programs publish a fee-for-service rate for U0005. Rates run from $20.00 in Georgia to $26.80 in Colorado, with a median of $25.00.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 8
- Median rate
- $25.00units vary by state
- Highest
- $26.80Colorado
- Medicare (non-facility)
- —not on the physician fee schedule
U0005 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) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $26.80since 2024-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2024-2025 Rate |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $25.00since 2024-09-01 | — | — | Plans negotiate; applies out of network | — | Rates for Clinical Laboratory Services ( |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $25.00since 2021-01-01 | — | — | 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) | $25.00since 2021-01-01 | — | — | Not classified | — | NJMMIS Coronavirus Services procedure co |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $25.00since 2023-05-11 | — | — | Plans negotiate; applies out of network | — | ODM CPT/HCPCS procedure code changes (Cl |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service | $25.00since 2024-03-04 | — | — | Plans negotiate; applies out of network | — | Medicaid Fee-For-Service (FFS) Fee Sched |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $22.50since 2022-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, March 20 |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $20.00since 2021-07-01 | — | — | Plans negotiate; applies out of network | — | Lab Max Allowable_ (005) (in Zipped Fee |
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 U0005?
It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $25.00. Colorado pays the most ($26.80) and Georgia the least ($20.00).
Which state pays the highest Medicaid rate for U0005?
Colorado, at $26.80, effective 2024-07-01.
Do managed-care plans pay the same rate for U0005?
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.