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Billing code 86051 · Lab & pathology

86051 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $10.17 for 86051 across 43 states, from $5.76 in Nevada to $12.45 in Texas.

Data as of Oct 5, 202643 statesEvery rate links to its official source

States publishing
43
National median
$10.17units vary by state
Lowest
$5.76Nevada
Highest
$12.45Texas
Answer

What does Medicaid pay for 86051?

43 state Medicaid programs publish a fee-for-service rate for 86051. The national median is $10.17 (units differ between states). Texas pays the most, $12.45, and Nevada the least, $5.76, a 2.2x spread.

State ranking

86051 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 43 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Texas Source · since 2019-07-04$12.45——Plans negotiate; applies out of network—
2Montana Source · since 2022-01-01$11.53——Not classified—
3Wisconsin Source · since 2022-01-01$11.53——Plans negotiate; applies out of network—
21Oklahoma Source · since 2024-01-01$10.26——Plans must pay at least this—
22Massachusetts Source · since 2024-09-01$10.17——Plans negotiate; applies out of network—
23Virginia Source · since 2022-01-01$10.15——Plans negotiate; applies out of network—
42Florida Source · since 2026-01-01$6.17——Plans negotiate; applies out of network—
43Nevada Source · since 2022-01-01$5.76——Plans negotiate; applies out of network—
See all 43 states for 86051 — start free

35 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 86051 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 86051?

It depends on the state. Of the 43 states with a published fee-for-service rate, the median is $10.17. Texas pays the most ($12.45) and Nevada the least ($5.76).

Which state pays the highest Medicaid rate for 86051?

Texas, at $12.45, effective 2019-07-04.

Do managed-care plans pay the same rate for 86051?

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.