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Billing code 84255 · Lab & pathology

84255 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $22.98 for 84255 across 48 states, from $11.41 in Virginia to $36.46 in Arkansas.

Data as of Oct 5, 202648 statesEvery rate links to its official source

States publishing
48
National median
$22.98units vary by state
Lowest
$11.41Virginia
Highest
$36.46Arkansas
Answer

What does Medicaid pay for 84255?

48 state Medicaid programs publish a fee-for-service rate for 84255. The national median is $22.98 (units differ between states). Arkansas pays the most, $36.46, and Virginia the least, $11.41, a 3.2x spread.

State ranking

84255 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 48 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Arkansas Source · since 2025-03-26$36.46——Not classified—
2Georgia Source · since 2017-01-01$32.10——Plans negotiate; applies out of network—
3North Carolina Source · since 2025-10-01$31.49——Plans must pay at least this—
24Missouri Source · since 2026-07-01$22.98——Plans negotiate; applies out of network—
25Mississippi Source · since 2022-07-01$22.98——Plans must pay at least this—
26West Virginia Source · since 2023-04-01$22.98——Plans negotiate; applies out of network—
47Florida Source · since 2026-01-01$12.57——Plans negotiate; applies out of network—
48Virginia Source · since 2014-07-01$11.41——Plans negotiate; applies out of network—
See all 48 states for 84255 — start free

40 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 84255 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 84255?

It depends on the state. Of the 48 states with a published fee-for-service rate, the median is $22.98. Arkansas pays the most ($36.46) and Virginia the least ($11.41).

Which state pays the highest Medicaid rate for 84255?

Arkansas, at $36.46, effective 2025-03-26.

Do managed-care plans pay the same rate for 84255?

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.