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Billing code 81523 · Lab & pathology

81523 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $3,444.98 for 81523 across 37 states, from $1,936.50 in Nevada to $3,873.00 in Montana.

Data as of Oct 5, 202637 statesEvery rate links to its official source

States publishing
37
National median
$3,444.98units vary by state
Lowest
$1,936.50Nevada
Highest
$3,873.00Montana
Answer

What does Medicaid pay for 81523?

37 state Medicaid programs publish a fee-for-service rate for 81523. The national median is $3,444.98 (units differ between states). Montana pays the most, $3,873.00, and Nevada the least, $1,936.50, a 2.0x spread.

State ranking

81523 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 37 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Montana Source · since 2022-01-01$3,873.00——Not classified—
2Arizona Source · since 2024-01-01$3,873.00——Plans negotiate; applies out of network—
3California Source · since 2026-10-01$3,873.00——Plans negotiate; applies out of network—
18West Virginia Source · since 2023-04-01$3,485.70——Plans negotiate; applies out of network—
19Oklahoma Source · since 2024-01-01$3,444.98——Plans must pay at least this—
20Massachusetts Source · since 2024-09-01$3,415.50——Plans negotiate; applies out of network—
36Florida Source · since 2026-01-01$2,091.42——Plans negotiate; applies out of network—
37Nevada Source · since 2022-01-01$1,936.50——Plans negotiate; applies out of network—
See all 37 states for 81523 — start free

29 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 81523 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 81523?

It depends on the state. Of the 37 states with a published fee-for-service rate, the median is $3,444.98. Montana pays the most ($3,873.00) and Nevada the least ($1,936.50).

Which state pays the highest Medicaid rate for 81523?

Montana, at $3,873.00, effective 2022-01-01.

Do managed-care plans pay the same rate for 81523?

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.