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Billing code 81025 · Lab & pathology

81025 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $7.71 for 81025 across 50 states, from $2.02 in New York to $15.50 in New Jersey.

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

States publishing
50
National median
$7.71units vary by state
Lowest
$2.02New York
Highest
$15.50New Jersey
Answer

What does Medicaid pay for 81025?

50 state Medicaid programs publish a fee-for-service rate for 81025. The national median is $7.71 (units differ between states). New Jersey pays the most, $15.50, and New York the least, $2.02 per unit, a 7.7x spread.

State ranking

81025 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
1New Jersey Source · since 2025-01-01$15.50——Not classified—
2New Mexico Source · since 2023-07-01$10.33——Plans must pay at least this—
3Texas Source · since 2019-07-04$9.29——Plans negotiate; applies out of network—
25Wyoming Source · since 2025-09-01$7.75——Not classified—
26Oklahoma Source · since 2024-01-01$7.66——Plans must pay at least this—
27Massachusetts Source · since 2024-09-01$7.59——Plans negotiate; applies out of network—
49California Source · since 2026-10-01$2.80——Plans negotiate; applies out of network—
50New York Source · since 2023-01-01$2.02unit—Plans negotiate; applies out of network—
See all 50 states for 81025 — 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 81025 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 81025?

It depends on the state. Of the 50 states with a published fee-for-service rate, the median is $7.71. New Jersey pays the most ($15.50) and New York the least ($2.02 per unit).

Which state pays the highest Medicaid rate for 81025?

New Jersey, at $15.50, effective 2025-01-01.

Do managed-care plans pay the same rate for 81025?

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.