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Billing code 81200 · Lab & pathology

81200 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $43.00 for 81200 across 37 states, from $13.50 in Arizona to $193.10 in Kansas.

Data as of Oct 5, 202637 statesEvery rate links to its official source

States publishing
37
National median
$43.00units vary by state
Lowest
$13.50Arizona
Highest
$193.10Kansas
Answer

What does Medicaid pay for 81200?

37 state Medicaid programs publish a fee-for-service rate for 81200. The national median is $43.00 (units differ between states). Kansas pays the most, $193.10, and Arizona the least, $13.50 per A, a 14.3x spread.

State ranking

81200 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 37 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Kansas Source · since 2013-01-01$193.10——Plans must pay at least this—
2Arkansas Source · since 2025-03-26$173.10——Not classified—
3Pennsylvania Source · since 2014-06-23$125.52——Plans negotiate; applies out of network—
18Delaware Source · since 2024-01-01$46.31——Plans negotiate; applies out of network—
19North Carolina Source · since 2025-10-01$43.00——Plans must pay at least this—
20Missouri Source · since 2026-07-01$42.53——Plans negotiate; applies out of network—
36Florida Source · since 2026-01-01$25.52——Plans negotiate; applies out of network—
37Arizona Source · since 2021-10-01$13.50A—Plans negotiate; applies out of network—
See all 37 states for 81200 — start free

29 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 81200 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 81200?

It depends on the state. Of the 37 states with a published fee-for-service rate, the median is $43.00. Kansas pays the most ($193.10) and Arizona the least ($13.50 per A).

Which state pays the highest Medicaid rate for 81200?

Kansas, at $193.10, effective 2013-01-01.

Do managed-care plans pay the same rate for 81200?

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.