Massachusetts Medicaid rate for CPT 12001
MassHealth pays $72.71 for CPT 12001 in its October 2026 fee-for-service schedule: the 16th-lowest of 45 state Medicaid programs, at 84% of the $86.45 median.
- Non-facility rate
- $72.71
- Rank
- 30 of 45
- vs. state median
- 84%
- vs. MA Medicare
- 56-62%
What MassHealth publishes for 12001
16th-lowest of 45 · 84% 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
12001 in neighboring states
Each state's comparable non-facility rate for 12001 in its current schedule.
| State | Rate | vs. Massachusetts |
|---|---|---|
| Connecticut | $76.33 | +5% |
| New Hampshire | $32.29 | -56% |
| Rhode Island | $25.20 | -65% |
| Vermont | $94.30 | +30% |
12001 in every state
Map and ranking of every state program that prices 12001.
Compare 12001 across states12001 under Medicare
Medicare's 2026 non-facility payment for 12001 in Massachusetts is $117.38 to $129.97 across its 2 payment localities; MassHealth's rate is 56-62% of that. The national amount before geographic adjustment is $113.897.
See 12001 Medicare ratesSee Massachusetts's full schedule: all 7,483 codes, every published period, and commercial payer rates for 12001.
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