Skip to content
Billing code 81294 · Lab & pathology

81294 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $181.10 for 81294 across 44 states, from $13.50 in Arizona to $360.00 in Georgia.

Data as of Oct 5, 202644 statesEvery rate links to its official source

States publishing
44
National median
$181.10units vary by state
Lowest
$13.50Arizona
Highest
$360.00Georgia
Answer

What does Medicaid pay for 81294?

44 state Medicaid programs publish a fee-for-service rate for 81294. The national median is $181.10 (units differ between states). Georgia pays the most, $360.00, and Arizona the least, $13.50 per A, a 26.7x spread.

State ranking

81294 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 44 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Georgia Source · since 2017-01-01$360.00——Plans negotiate; applies out of network—
2New Mexico Source · since 2024-11-01$242.89——Plans must pay at least this—
3Texas Source · since 2019-07-04$218.59——Plans negotiate; applies out of network—
22West Virginia Source · since 2023-04-01$182.16——Plans negotiate; applies out of network—
23Oklahoma Source · since 2024-01-01$180.03——Plans must pay at least this—
24Massachusetts Source · since 2024-09-01$178.49——Plans negotiate; applies out of network—
43Nevada Source · since 2023-10-01$95.34——Plans negotiate; applies out of network—
44Arizona Source · since 2021-10-01$13.50A—Plans negotiate; applies out of network—
See all 44 states for 81294 — start free

36 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.

  • Source for every rate
  • Full rate history
  • CSV and API export

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 81294 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 81294?

It depends on the state. Of the 44 states with a published fee-for-service rate, the median is $181.10. Georgia pays the most ($360.00) and Arizona the least ($13.50 per A).

Which state pays the highest Medicaid rate for 81294?

Georgia, at $360.00, effective 2017-01-01.

Do managed-care plans pay the same rate for 81294?

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.