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Billing code 81003 · Lab & pathology

81003 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $2.09 for 81003 across 50 states, from $0.80 in Rhode Island to $3.20 in Arkansas.

Data as of Oct 5, 202650 statesEvery rate links to its official source

States publishing
50
National median
$2.09units vary by state
Lowest
$0.80Rhode Island
Highest
$3.20Arkansas
Answer

What does Medicaid pay for 81003?

50 state Medicaid programs publish a fee-for-service rate for 81003. The national median is $2.09 (units differ between states). Arkansas pays the most, $3.20, and Rhode Island the least, $0.80, a 4.0x spread.

State ranking

81003 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 50 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Arkansas Source · since 2025-06-04$3.20——Not classified—
2Iowa Source · since 2024-01-01$3.18——Plans must pay at least this—
3Pennsylvania Source · since 2008-07-01$3.10——Plans negotiate; applies out of network—
25Connecticut Source · since 2015-01-01$2.14——Not classified—
26Arizona Source · since 2026-07-01$2.03——Plans negotiate; applies out of network—
27Missouri Source · since 2026-07-01$2.03——Plans negotiate; applies out of network—
49Florida Source · since 2026-01-01$1.18——Plans negotiate; applies out of network—
50Rhode Island Source · since 2006-05-01$0.80——Plans negotiate; applies out of network—
See all 50 states for 81003 — start free

42 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

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Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track 81003 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
FAQ

Frequently asked questions

What does Medicaid pay for 81003?

It depends on the state. Of the 50 states with a published fee-for-service rate, the median is $2.09. Arkansas pays the most ($3.20) and Rhode Island the least ($0.80).

Which state pays the highest Medicaid rate for 81003?

Arkansas, at $3.20, effective 2025-06-04.

Do managed-care plans pay the same rate for 81003?

Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The workspace shows the rule for each state, cited to the contract or statute.