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Billing code 86612 · Lab & pathology

86612 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $11.61 for 86612 across 50 states, from $5.81 in Wyoming to $18.42 in Arkansas.

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

States publishing
50
National median
$11.61units vary by state
Lowest
$5.81Wyoming
Highest
$18.42Arkansas
Answer

What does Medicaid pay for 86612?

50 state Medicaid programs publish a fee-for-service rate for 86612. The national median is $11.61 (units differ between states). Arkansas pays the most, $18.42, and Wyoming the least, $5.81, a 3.2x spread.

State ranking

86612 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$18.42——Not classified—
2Iowa Source · since 2013-07-01$18.33——Plans must pay at least this—
3Pennsylvania Source · since 2009-04-02$17.83——Plans negotiate; applies out of network—
25Missouri Source · since 2026-07-01$11.61——Plans negotiate; applies out of network—
26Mississippi Source · since 2022-07-01$11.61——Plans must pay at least this—
27West Virginia Source · since 2023-04-01$11.61——Plans negotiate; applies out of network—
49Virginia Source · since 2014-07-01$5.94——Plans negotiate; applies out of network—
50Wyoming Source · since 2021-01-01$5.81——Not classified—
See all 50 states for 86612 — 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 86612 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 86612?

It depends on the state. Of the 50 states with a published fee-for-service rate, the median is $11.61. Arkansas pays the most ($18.42) and Wyoming the least ($5.81).

Which state pays the highest Medicaid rate for 86612?

Arkansas, at $18.42, effective 2025-03-26.

Do managed-care plans pay the same rate for 86612?

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.