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Billing code G0479 · Physician & professional

G0479 Medicaid reimbursement rate by state (2026)

Drug test(s), presumptive, any number of drug classes. Medicaid pays a median of $47.55 for G0479 across 5 states, from $10.00 in Kansas to $52.06 in New Hampshire.

Data as of Oct 5, 20265 statesEvery rate links to its official source

States publishing
5
National median
$47.55units vary by state
Lowest
$10.00Kansas
Highest
$52.06New Hampshire
Answer

What does Medicaid pay for G0479?

5 state Medicaid programs publish a fee-for-service rate for G0479. The national median is $47.55 (units differ between states). New Hampshire pays the most, $52.06, and Kansas the least, $10.00, a 5.2x spread.

State ranking

G0479 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 5 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1New Hampshire Source · since 2023-07-01$52.06——Plans negotiate; applies out of network—
2Rhode Island Source · since 2016-01-01$47.55——Plans negotiate; applies out of network—
3Massachusetts Source · since 2016-01-01$47.55——Plans negotiate; applies out of network—
See all 5 states for G0479 — start free

2 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

  • Source for every rate
  • Full rate history
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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; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track G0479 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
Guide

How to read this table

  • Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for G0479, so the order is by published amount and is not a like-for-like rank.
  • Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. Each state lists a single rate for G0479.
  • Unit. None of the 5 schedules prints a separate unit for G0479, so each amount is a flat payment for one service as the code defines it.
  • Per hour. G0479 is not billed in time units in these states, so no hourly figure is shown.
  • Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
  • % of Medicare. No Medicare physician fee schedule amount is on file for G0479, so there is no percentage.
  • Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Context

Why G0479 rates differ between states

Published rates for G0479 run from $10.00 in Kansas to $52.06 in New Hampshire, a 5.2x gap in the same unit. Half the states pay more than the median of $47.55 and half pay less. The usual reasons for a spread like this in physician & professional rates:

  • Some states pay physician services as a percentage of the Medicare fee schedule; others keep a schedule of their own that may not have been rebased for years.
  • Each state sets its own physician conversion factor or fee for every code, and many update them on a state budget cycle rather than on Medicare's calendar.
  • Modifiers such as professional or technical component, bilateral, multiple procedure and assistant at surgery change the amount paid, and states apply them with their own percentages.

Timing matters too. None of the states changed its rate for G0479 in 2026, while 3 states still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.

Managed care

What managed-care plans pay for G0479

No managed-care plan publishes what it pays for G0479. What is public is the rule each state's plan contracts set, and that rule decides how much the published rate matters when you contract with a plan.

In 4 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 1 state is not classified yet.

  • Plans negotiate; the published rate applies out of network (4 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.

Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example New Hampshire managed care.

Billing

Units and billing for G0479

G0479 is a HCPCS Level II professional services code in the physician & professional line, billed mostly by physicians, nurse practitioners, physician assistants and other licensed practitioners. G codes describe professional services and procedures that have no CPT code, or that payers define more narrowly. Many are timed, so check the unit before comparing.

Where a state publishes separate facility and non-facility amounts, the non-facility (office) amount is usually higher because the practice carries the overhead. Physician-fee-schedule codes are billed per service: one unit is one occurrence unless the code itself is defined by time or quantity.

Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.

FAQ

Frequently asked questions

What does Medicaid pay for G0479?

It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $47.55. New Hampshire pays the most ($52.06) and Kansas the least ($10.00).

Which state pays the highest Medicaid rate for G0479?

New Hampshire, at $52.06, effective 2023-07-01.

Which state pays the lowest Medicaid rate for G0479?

Kansas, at $10.00, effective 2016-01-01.

What unit is G0479 billed in?

None of the 5 schedules prints a separate unit for G0479, so each amount is a flat payment for one service as the code defines it.

Do managed-care plans pay the same rate for G0479?

Not necessarily. In 4 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 1 state is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.