Massachusetts Medicaid rate for CPT 11042
MassHealth pays $100.25 for CPT 11042 in its October 2026 fee-for-service schedule: the 22nd-highest of 45 state Medicaid programs, at 102% of the $98.39 median.
- Non-facility rate
- $100.25
- Rank
- 22 of 45
- vs. state median
- 102%
- vs. MA Medicare
- 66-73%
What MassHealth publishes for 11042
22nd-highest of 45 · 102% of median
- Schedule
- October 2026
- In effect since
- Oct 1, 2026
Unmodified non-facility fee-for-service rate from the state's published file. Managed-care contracts, supplemental payments, and claim-specific adjustments can change what is paid. 101 CMR 317.00, Rates for Medicine Services
11042 in neighboring states
Each state's comparable non-facility rate for 11042 in its current schedule.
| State | Rate | vs. Massachusetts |
|---|---|---|
| Connecticut | $80.89 | -19% |
| New Hampshire | $27.38 | -73% |
| Rhode Island | $25.20 | -75% |
| Vermont | $110.83 | +11% |
11042 in every state
Map and ranking of every state program that prices 11042.
Compare 11042 across states11042 under Medicare
Medicare's 2026 non-facility payment for 11042 in Massachusetts is $137.31 to $152.00 across its 2 payment localities; MassHealth's rate is 66-73% of that. The national amount before geographic adjustment is $132.602.
See 11042 Medicare ratesSee Massachusetts's full schedule: all 7,483 codes, every published period, and commercial payer rates for 11042.
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