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Billing code 81249 · Lab & pathology

81249 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $540.00 for 81249 across 32 states, from $355.39 in Florida to $648.00 in Texas.

Data as of Oct 5, 202632 statesEvery rate links to its official source

States publishing
32
National median
$540.00units vary by state
Lowest
$355.39Florida
Highest
$648.00Texas
Answer

What does Medicaid pay for 81249?

32 state Medicaid programs publish a fee-for-service rate for 81249. The national median is $540.00 (units differ between states). Texas pays the most, $648.00, and Florida the least, $355.39, a 1.8x spread.

State ranking

81249 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 32 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Texas Source · since 2019-07-04$648.00——Plans negotiate; applies out of network—
2Montana Source · since 2018-07-01$600.00——Not classified—
3Indiana Source · since 2024-07-01$600.00unit—Plans must pay at least this—
16Mississippi Source · since 2026-07-01$540.00——Plans must pay at least this—
17West Virginia Source · since 2023-04-01$540.00——Plans negotiate; applies out of network—
18Oklahoma Source · since 2024-01-01$533.69——Plans must pay at least this—
31Illinois Source · since 2024-04-01$408.66——Plans negotiate; applies out of network—
32Florida Source · since 2026-01-01$355.39——Plans negotiate; applies out of network—
See all 32 states for 81249 — start free

24 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 81249 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 81249?

It depends on the state. Of the 32 states with a published fee-for-service rate, the median is $540.00. Texas pays the most ($648.00) and Florida the least ($355.39).

Which state pays the highest Medicaid rate for 81249?

Texas, at $648.00, effective 2019-07-04.

Do managed-care plans pay the same rate for 81249?

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.