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Billing code 86331 · Lab & pathology

86331 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $11.58 for 86331 across 48 states, from $5.90 in California to $17.02 in Iowa.

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

States publishing
48
National median
$11.58units vary by state
Lowest
$5.90California
Highest
$17.02Iowa
Answer

What does Medicaid pay for 86331?

48 state Medicaid programs publish a fee-for-service rate for 86331. The national median is $11.58 (units differ between states). Iowa pays the most, $17.02, and California the least, $5.90, a 2.9x spread.

State ranking

86331 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
1Iowa Source · since 2013-07-01$17.02——Plans must pay at least this—
2Arkansas Source · since 2025-03-26$16.21——Not classified—
3Georgia Source · since 2018-10-01$15.08——Plans negotiate; applies out of network—
24Vermont Source · since 2025-01-01$11.68——Not classified—
25Illinois Source · since 2013-01-01$11.48——Plans negotiate; applies out of network—
26Connecticut Source · since 2015-01-01$11.44——Not classified—
47Florida Source · since 2026-01-01$6.32——Plans negotiate; applies out of network—
48California Source · since 2026-10-01$5.90——Plans negotiate; applies out of network—
See all 48 states for 86331 — 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 86331 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 86331?

It depends on the state. Of the 48 states with a published fee-for-service rate, the median is $11.58. Iowa pays the most ($17.02) and California the least ($5.90).

Which state pays the highest Medicaid rate for 86331?

Iowa, at $17.02, effective 2013-07-01.

Do managed-care plans pay the same rate for 86331?

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.