G0250 Medicaid Rate by State

Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequently than once a week; billing units of service include 4 tests

17 state Medicaid programs publish a fee-for-service rate for G0250 (physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequently than once a week; billing units of service include 4 tests), ranging from $6.28 in Maine to $11.81 in Montana, with a median of 83% of the national Medicare amount.

Every state, kept current

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Publishing states

17

Median % of Medicare

83%

Rate range

$6.28 - $11.81

G0250 rates in every publishing state

StateMedicaid rate% of MedicarePrior authVintage
Arizona$9.68107.3%--2024
Hawaii$8.8698.2%--2025
Iowa$7.7886.3%--2024
Kansas$7.8587%--2024
Kentucky$7.4382.4%--2026
Louisiana$8.6495.8%--2026
Maine$6.2869.6%--2026
Minnesota$6.6874.1%--2026
Montana$11.81130.9%--2026
North Carolina$7.1779.5%--2025
North Dakota$9.76108.2%Not required2026
New Hampshire$6.5472.5%Not required2026
Oregon$7.26*80.5%--2026
Vermont$7.5083.1%--2026
Wisconsin$6.6373.5%--2011
West Virginia$6.3470.3%--2026
Wyoming$7.4983%--2026

Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * are representative published variants or methodology-derived rates. "--" in the prior-auth column means the state publishes no PA flag.

Related physician codes

All 136 codes from G0008 to G0659 or every physician code by number.

Frequently asked questions

How much does Medicaid pay for G0250?

17 state Medicaid programs publish a fee-for-service rate for G0250 (physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequently than once a week; billing units of service include 4 tests), ranging from $6.28 in Maine to $11.81 in Montana, with a median of 83% of the national Medicare amount. The full table on this page lists every publishing state's current rate.

Which state pays the most for G0250?

Montana publishes the highest Medicaid rate for G0250 at $11.81 (130.9% of the national Medicare amount). Maine publishes the lowest at $6.28.

Does G0250 require prior authorization under Medicaid?

No publishing state flags G0250 with a prior-authorization indicator on its fee schedule. Absence of a flag means the state publishes none, not that PA is never required - confirm through the state's provider manual.