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Billing code 81303 · Lab & pathology

81303 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $105.91 for 81303 across 29 states, from $13.50 in Arizona to $197.67 in Pennsylvania.

Data as of Oct 5, 202629 statesEvery rate links to its official source

States publishing
29
National median
$105.91units vary by state
Lowest
$13.50Arizona
Highest
$197.67Pennsylvania
Answer

What does Medicaid pay for 81303?

29 state Medicaid programs publish a fee-for-service rate for 81303. The national median is $105.91 (units differ between states). Pennsylvania pays the most, $197.67, and Arizona the least, $13.50 per A, a 14.6x spread.

State ranking

81303 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 29 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Pennsylvania Source · since 2014-06-23$197.67——Plans negotiate; applies out of network—
2Texas Source · since 2019-07-04$129.60——Plans negotiate; applies out of network—
3Montana Source · since 2018-07-01$120.00——Not classified—
14Oklahoma Source · since 2024-01-01$106.74——Plans must pay at least this—
15Wisconsin Source · since 2012-01-01$105.91——Plans negotiate; applies out of network—
16Massachusetts Source · since 2024-09-01$105.83——Plans negotiate; applies out of network—
28Florida Source · since 2026-01-01$64.80——Plans negotiate; applies out of network—
29Arizona Source · since 2021-10-01$13.50A—Plans negotiate; applies out of network—
See all 29 states for 81303 — start free

21 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 81303 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 81303?

It depends on the state. Of the 29 states with a published fee-for-service rate, the median is $105.91. Pennsylvania pays the most ($197.67) and Arizona the least ($13.50 per A).

Which state pays the highest Medicaid rate for 81303?

Pennsylvania, at $197.67, effective 2014-06-23.

Do managed-care plans pay the same rate for 81303?

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.