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Billing code 86308 · Lab & pathology

86308 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $4.86 for 86308 across 50 states, from $2.49 in Florida to $7.39 in Arkansas.

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

States publishing
50
National median
$4.86units vary by state
Lowest
$2.49Florida
Highest
$7.39Arkansas
Answer

What does Medicaid pay for 86308?

50 state Medicaid programs publish a fee-for-service rate for 86308. The national median is $4.86 (units differ between states). Arkansas pays the most, $7.39, and Florida the least, $2.49, a 3.0x spread.

State ranking

86308 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$7.39——Not classified—
2Iowa Source · since 2024-01-01$7.35——Plans must pay at least this—
3Pennsylvania Source · since 2008-07-01$7.15——Plans negotiate; applies out of network—
25Connecticut Source · since 2015-01-01$4.94——Not classified—
26New York Source · since 2020-05-29$4.78——Plans negotiate; applies out of network—
27Illinois Source · since 2013-01-01$4.67——Plans negotiate; applies out of network—
49Nevada Source · since 2017-01-01$3.53——Plans negotiate; applies out of network—
50Florida Source · since 2026-01-01$2.49——Plans negotiate; applies out of network—
See all 50 states for 86308 — 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 86308 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
Guide

How to read this table

  • Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for 86308, so the order is by published amount and is not a like-for-like rank.
  • Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 26 of the 50 states list more than one rate for 86308, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
  • Unit. Of the 50 states, 1 publish 86308 per unit, and 49 schedules print no unit at all (a flat amount per service).
  • Per hour. 86308 is not billed in time units in these states, so no hourly figure is shown.
  • Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
  • % of Medicare. No Medicare physician fee schedule amount is on file for 86308, so there is no percentage.
  • Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Context

Why 86308 rates differ between states

Published rates for 86308 run from $2.49 in Florida to $7.39 in Arkansas, a 3.0x gap in the same unit. Half the states pay more than the median of $4.86 and half pay less. The usual reasons for a spread like this in lab & pathology rates:

  • Pathology services with an interpretation have professional and technical components that states price separately.
  • Some states bundle certain tests into panels or into facility payments, so the separately billable amount differs.
  • Fees for newer molecular and genetic tests are often set case by case, so fewer states publish them and the published amounts spread widely.

Timing matters too. 12 states set the current rate for 86308 in 2026 or later, while 20 states still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.

Managed care

What managed-care plans pay for 86308

No managed-care plan publishes what it pays for 86308. What is public is the rule each state's plan contracts set, and that rule decides how much the published rate matters when you contract with a plan.

In 8 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 26 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 16 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (26 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.
  • Plans must pay at least the published rate (8 states). The published rate is your floor. Negotiate up from it, and if a plan pays less, the contract provision is the basis for a payment dispute.

Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example Arkansas managed care.

Billing

Units and billing for 86308

86308 is a CPT pathology and laboratory code in the lab & pathology line, billed mostly by independent laboratories, hospital labs and pathology groups. Laboratory codes are paid per test; a panel is paid as one code, not as the sum of its tests. Pathology codes with an interpretation can be split into professional and technical components.

Pathology interpretation can be billed with modifier 26 when the laboratory and the pathologist bill separately. Laboratory tests are billed per test, and a panel is paid as a single code rather than as the sum of its component tests.

Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.

FAQ

Frequently asked questions

What does Medicaid pay for 86308?

It depends on the state. Of the 50 states with a published fee-for-service rate, the median is $4.86. Arkansas pays the most ($7.39) and Florida the least ($2.49).

Which state pays the highest Medicaid rate for 86308?

Arkansas, at $7.39, effective 2025-03-26.

Which state pays the lowest Medicaid rate for 86308?

Florida, at $2.49, effective 2026-01-01.

What unit is 86308 billed in?

Of the 50 states, 1 publish 86308 per unit, and 49 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for 86308?

Not necessarily. In 8 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 26 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 16 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.