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Billing code 85260 · Lab & pathology

85260 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $16.11 for 85260 across 50 states, from $8.15 in Virginia to $25.58 in Arkansas.

Data as of Oct 5, 202650 statesEvery rate links to its official source

States publishing
50
National median
$16.11units vary by state
Lowest
$8.15Virginia
Highest
$25.58Arkansas
Answer

What does Medicaid pay for 85260?

50 state Medicaid programs publish a fee-for-service rate for 85260. The national median is $16.11 (units differ between states). Arkansas pays the most, $25.58, and Virginia the least, $8.15, a 3.1x spread.

State ranking

85260 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 50 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Arkansas Source · since 2025-03-26$25.58——Not classified—
2Georgia Source · since 2017-01-01$22.52——Plans negotiate; applies out of network—
3North Carolina Source · since 2025-10-01$22.09——Plans must pay at least this—
25Missouri Source · since 2026-07-01$16.11——Plans negotiate; applies out of network—
26Mississippi Source · since 2022-07-01$16.11——Plans must pay at least this—
27West Virginia Source · since 2023-04-01$16.11——Plans negotiate; applies out of network—
49Florida Source · since 2026-01-01$8.76——Plans negotiate; applies out of network—
50Virginia Source · since 2014-07-01$8.15——Plans negotiate; applies out of network—
See all 50 states for 85260 — start free

42 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 85260 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 85260?

It depends on the state. Of the 50 states with a published fee-for-service rate, the median is $16.11. Arkansas pays the most ($25.58) and Virginia the least ($8.15).

Which state pays the highest Medicaid rate for 85260?

Arkansas, at $25.58, effective 2025-03-26.

Do managed-care plans pay the same rate for 85260?

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.