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Billing code 81212 · Lab & pathology

81212 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $380.16 for 81212 across 47 states, from $13.50 in Arizona to $528.00 in New Mexico.

Data as of Oct 5, 202647 statesEvery rate links to its official source

States publishing
47
National median
$380.16units vary by state
Lowest
$13.50Arizona
Highest
$528.00New Mexico
Answer

What does Medicaid pay for 81212?

47 state Medicaid programs publish a fee-for-service rate for 81212. The national median is $380.16 (units differ between states). New Mexico pays the most, $528.00, and Arizona the least, $13.50 per A, a 39.1x spread.

State ranking

81212 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 47 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1New Mexico Source · since 2024-11-01$528.00——Plans must pay at least this—
2Texas Source · since 2019-07-04$475.20——Plans negotiate; applies out of network—
3Rhode Island Source · since 2022-07-01$440.00——Plans negotiate; applies out of network—
23New Hampshire Source · since 2025-01-01$380.60——Plans negotiate; applies out of network—
24Idaho Source · since 2025-09-01$380.16——Not classified—
25Louisiana Source · since 2025-07-01$374.00——Plans must pay at least this—
46Maine Source · since 2016-07-01$123.69——Not classified—
47Arizona Source · since 2021-10-01$13.50A—Plans negotiate; applies out of network—
See all 47 states for 81212 — start free

39 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 81212 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 81212?

It depends on the state. Of the 47 states with a published fee-for-service rate, the median is $380.16. New Mexico pays the most ($528.00) and Arizona the least ($13.50 per A).

Which state pays the highest Medicaid rate for 81212?

New Mexico, at $528.00, effective 2024-11-01.

Do managed-care plans pay the same rate for 81212?

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.