West Virginia Medicaid rate for CPT 11042
West Virginia Medicaid pays $88.82 for CPT 11042 in its April 2026 fee-for-service schedule: the 21st-lowest of 45 state Medicaid programs, at 90% of the $98.39 median.
- Non-facility rate
- $88.82
- Rank
- 25 of 45
- vs. state median
- 90%
- vs. WV Medicare
- 73%
What West Virginia Medicaid publishes for 11042
21st-lowest of 45 · 90% of median
- Schedule
- April 2026
- In effect since
- Apr 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. BMS Physician RBRVS Fee Schedules
11042 in neighboring states
Each state's comparable non-facility rate for 11042 in its current schedule.
| State | Rate | vs. West Virginia |
|---|---|---|
| Kentucky | $48.18 | -46% |
| Maryland | $92.58 | +4% |
| Ohio | $66.97 | -25% |
| Pennsylvania | $33.00 | -63% |
| Virginia | $114.87 | +29% |
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 West Virginia is $121.96; West Virginia Medicaid's rate is 73% of that. The national amount before geographic adjustment is $132.602.
See 11042 Medicare ratesSee West Virginia's full schedule: all 7,002 codes, every published period, and commercial payer rates for 11042.
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