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Billing code 85175 · Lab & pathology

85175 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $16.86 for 85175 across 49 states, from $1.46 in Virginia to $21.99 in Texas.

Data as of Oct 5, 202649 statesEvery rate links to its official source

States publishing
49
National median
$16.86units vary by state
Lowest
$1.46Virginia
Highest
$21.99Texas
Answer

What does Medicaid pay for 85175?

49 state Medicaid programs publish a fee-for-service rate for 85175. The national median is $16.86 (units differ between states). Texas pays the most, $21.99, and Virginia the least, $1.46, a 15.1x spread.

State ranking

85175 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 49 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Texas Source · since 2019-07-04$21.99——Plans negotiate; applies out of network—
2Montana Source · since 2018-07-01$20.37——Not classified—
3Nebraska Source · since 2026-07-01$20.37——Plans negotiate; applies out of network—
24Colorado Source · since 2026-07-01$16.97——Not classified—
25Michigan Source · since 2023-01-01$16.86——Plans negotiate; applies out of network—
26New Jersey Source · since 2025-01-01$16.30——Not classified—
48Nevada Source · since 2017-01-01$3.11——Plans negotiate; applies out of network—
49Virginia Source · since 2014-07-01$1.46——Plans negotiate; applies out of network—
See all 49 states for 85175 — start free

41 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 85175 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 85175?

It depends on the state. Of the 49 states with a published fee-for-service rate, the median is $16.86. Texas pays the most ($21.99) and Virginia the least ($1.46).

Which state pays the highest Medicaid rate for 85175?

Texas, at $21.99, effective 2019-07-04.

Do managed-care plans pay the same rate for 85175?

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.