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Billing code 81007 · Lab & pathology

81007 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $23.98 for 81007 across 49 states, from $0.66 in Nevada to $35.98 in New Mexico.

Data as of Oct 5, 202649 statesEvery rate links to its official source

States publishing
49
National median
$23.98units vary by state
Lowest
$0.66Nevada
Highest
$35.98New Mexico
Answer

What does Medicaid pay for 81007?

49 state Medicaid programs publish a fee-for-service rate for 81007. The national median is $23.98 (units differ between states). New Mexico pays the most, $35.98, and Nevada the least, $0.66, a 54.5x spread.

State ranking

81007 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 49 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1New Mexico Source · since 2023-07-01$35.98——Plans must pay at least this—
2Texas Source · since 2019-07-04$32.37——Plans negotiate; applies out of network—
3Montana Source · since 2018-07-01$29.98——Not classified—
24Colorado Source · since 2026-07-01$24.97——Not classified—
25New Jersey Source · since 2025-01-01$23.98——Not classified—
26Washington Source · since 2026-01-01$23.98——Plans negotiate; applies out of network—
48Florida Source · since 2026-01-01$1.95——Plans negotiate; applies out of network—
49Nevada Source · since 2017-01-01$0.66——Plans negotiate; applies out of network—
See all 49 states for 81007 — start free

41 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 81007 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 81007?

It depends on the state. Of the 49 states with a published fee-for-service rate, the median is $23.98. New Mexico pays the most ($35.98) and Nevada the least ($0.66).

Which state pays the highest Medicaid rate for 81007?

New Mexico, at $35.98, effective 2023-07-01.

Do managed-care plans pay the same rate for 81007?

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.