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G0499 Medicaid reimbursement rates by state

Hepatitis b screening in non-pregnant. 20 state Medicaid programs publish a fee-for-service rate for G0499 at the agency level. Rates run from $11.68 in Kansas to $115.02 in Utah, with a median of $27.63.

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

States publishing
20
Median rate
$27.63units vary by state
Highest
$115.02Utah
Medicare (non-facility)
—not on the physician fee schedule

G0499 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
UtahAgency provider · Utah Medicaid (fee-for-service, Traditional plan)$115.02⚠ over 3× mediansince 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$30.53since 2021-11-17——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$28.27since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Clinical
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$28.27since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$28.27since 2020-01-01unit—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)$28.27since 2020-01-01——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)$28.27since 2020-01-01——Plans negotiate; applies out of network—KY Medicaid Clinical Lab fee schedule (2
MontanaIndependent (non-agency) provider · Montana Medicaid and HMK Plus (fee-for-service)$28.27since 2020-01-01——Not classified—Montana Healthcare Programs fee schedule
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$28.27since 2026-06-01——Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$27.70since 2024-01-01——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)$27.56since 2025-01-01——Not classified—Vermont Medicaid Fee Schedule - HCPCS (i
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$25.44since 2026-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Independent L
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$24.93since 2024-09-01——Plans negotiate; applies out of network—Rates for Clinical Laboratory Services (
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$24.43since 2018-01-01——Not classified—MaineCare Fee Schedule (MaineCare UCR, H
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$23.40since 2023-01-01——Plans negotiate; applies out of network—MDHHS Child and Adolescent Health Center
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$22.62since 2026-01-01——Plans negotiate; applies out of network—HCA Physician-related services fee sched
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$22.62since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$22.39since 2018-01-01——Not classified—CMAP fee schedule: Lab October 2026
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$19.00since 2017-08-07——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$11.68since 2017-01-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched

Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 G0499?

It depends on the state. Of the 20 states with a published fee-for-service rate, the median is $27.63. Utah pays the most ($115.02) and Kansas the least ($11.68).

Which state pays the highest Medicaid rate for G0499?

Utah, at $115.02, effective 2026-07-01.

Do managed-care plans pay the same rate for G0499?

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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