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Billing code 81207 · Lab & pathology

81207 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $131.80 for 81207 across 45 states, from $13.50 in Arizona to $173.81 in New Mexico.

Data as of Oct 5, 202645 statesEvery rate links to its official source

States publishing
45
National median
$131.80units vary by state
Lowest
$13.50Arizona
Highest
$173.81New Mexico
Answer

What does Medicaid pay for 81207?

45 state Medicaid programs publish a fee-for-service rate for 81207. The national median is $131.80 (units differ between states). New Mexico pays the most, $173.81, and Arizona the least, $13.50 per A, a 12.9x spread.

State ranking

81207 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 45 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1New Mexico Source · since 2024-11-01$173.81——Plans must pay at least this—
2Kansas Source · since 2014-04-01$167.95——Plans must pay at least this—
3Texas Source · since 2021-11-17$156.42——Plans negotiate; applies out of network—
22Maine Source · since 2016-07-01$138.31——Not classified—
23North Carolina Source · since 2025-10-01$131.80——Plans must pay at least this—
24Missouri Source · since 2026-07-01$130.36——Plans negotiate; applies out of network—
44Florida Source · since 2026-01-01$23.52——Plans negotiate; applies out of network—
45Arizona Source · since 2021-10-01$13.50A—Plans negotiate; applies out of network—
See all 45 states for 81207 — start free

37 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 81207 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 81207?

It depends on the state. Of the 45 states with a published fee-for-service rate, the median is $131.80. New Mexico pays the most ($173.81) and Arizona the least ($13.50 per A).

Which state pays the highest Medicaid rate for 81207?

New Mexico, at $173.81, effective 2024-11-01.

Do managed-care plans pay the same rate for 81207?

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.