North Carolina Medicaid rate for CPT 11042
NC Medicaid pays $53.26 for CPT 11042 in its January 2026 fee-for-service schedule: the 6th-lowest of 45 state Medicaid programs, at 54% of the $98.39 median.
- Non-facility rate
- $53.26
- Rank
- 40 of 45
- vs. state median
- 54%
- vs. NC Medicare
- 43%
What NC Medicaid publishes for 11042
6th-lowest of 45 · 54% of median
- Schedule
- January 2026
- In effect since
- Oct 1, 2025
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. NC Medicaid Physician Services Fee Schedules
11042 in neighboring states
Each state's comparable non-facility rate for 11042 in its current schedule.
| State | Rate | vs. North Carolina |
|---|---|---|
| Georgia | $62.57 | +17% |
| South Carolina | $84.54 | +59% |
| Virginia | $114.87 | +116% |
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 North Carolina is $124.63; NC Medicaid's rate is 43% of that. The national amount before geographic adjustment is $132.602.
See 11042 Medicare ratesSee North Carolina's full schedule: all 8,402 codes, every published period, and commercial payer rates for 11042.
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