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Billing code 81503 · Lab & pathology

81503 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $807.30 for 81503 across 21 states, from $150.00 in Kansas to $1,076.40 in New Mexico.

Data as of Oct 5, 202621 statesEvery rate links to its official source

States publishing
21
National median
$807.30units vary by state
Lowest
$150.00Kansas
Highest
$1,076.40New Mexico
Answer

What does Medicaid pay for 81503?

21 state Medicaid programs publish a fee-for-service rate for 81503. The national median is $807.30 (units differ between states). New Mexico pays the most, $1,076.40, and Kansas the least, $150.00, a 7.2x spread.

State ranking

81503 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 21 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1New Mexico Source · since 2024-11-01$1,076.40——Plans must pay at least this—
2Montana Source · since 2022-01-01$897.00——Not classified—
3California Source · since 2026-10-01$897.00——Plans negotiate; applies out of network—
10Missouri Source · since 2026-07-01$807.30——Plans negotiate; applies out of network—
11Mississippi Source · since 2026-07-01$807.30——Plans must pay at least this—
12Massachusetts Source · since 2024-09-01$791.04——Plans negotiate; applies out of network—
20Florida Source · since 2026-01-01$484.38——Plans negotiate; applies out of network—
21Kansas Source · since 2016-01-01$150.00——Not classified—
See all 21 states for 81503 — start free

13 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 81503 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 81503?

It depends on the state. Of the 21 states with a published fee-for-service rate, the median is $807.30. New Mexico pays the most ($1,076.40) and Kansas the least ($150.00).

Which state pays the highest Medicaid rate for 81503?

New Mexico, at $1,076.40, effective 2024-11-01.

Do managed-care plans pay the same rate for 81503?

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.