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Billing code 81237 · Lab & pathology

81237 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $154.52 for 81237 across 34 states, from $94.72 in Florida to $189.43 in Texas.

Data as of Oct 5, 202634 statesEvery rate links to its official source

States publishing
34
National median
$154.52units vary by state
Lowest
$94.72Florida
Highest
$189.43Texas
Answer

What does Medicaid pay for 81237?

34 state Medicaid programs publish a fee-for-service rate for 81237. The national median is $154.52 (units differ between states). Texas pays the most, $189.43, and Florida the least, $94.72, a 2.0x spread.

State ranking

81237 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 34 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Texas Source · since 2019-07-04$189.43——Plans negotiate; applies out of network—
2Arizona Source · since 2026-10-01$175.40——Plans negotiate; applies out of network—
3Minnesota Source · since 2019-01-01$175.40——Plans negotiate; applies out of network—
17Massachusetts Source · since 2024-09-01$154.68——Plans negotiate; applies out of network—
18Virginia Source · since 2019-01-01$154.35——Plans negotiate; applies out of network—
19New Hampshire Source · since 2025-01-01$151.72——Plans negotiate; applies out of network—
33New York Source · since 2020-05-29$106.29——Plans negotiate; applies out of network—
34Florida Source · since 2026-01-01$94.72——Plans negotiate; applies out of network—
See all 34 states for 81237 — start free

26 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 81237 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 81237?

It depends on the state. Of the 34 states with a published fee-for-service rate, the median is $154.52. Texas pays the most ($189.43) and Florida the least ($94.72).

Which state pays the highest Medicaid rate for 81237?

Texas, at $189.43, effective 2019-07-04.

Do managed-care plans pay the same rate for 81237?

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.