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Billing code 86821 · Lab & pathology

86821 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $35.89 for 86821 across 49 states, from $17.55 in Florida to $80.63 in Arkansas.

Data as of Oct 5, 202649 statesEvery rate links to its official source

States publishing
49
National median
$35.89units vary by state
Lowest
$17.55Florida
Highest
$80.63Arkansas
Answer

What does Medicaid pay for 86821?

49 state Medicaid programs publish a fee-for-service rate for 86821. The national median is $35.89 (units differ between states). Arkansas pays the most, $80.63, and Florida the least, $17.55, a 4.6x spread.

State ranking

86821 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 49 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Arkansas Source · since 2025-03-26$80.63——Not classified—
2Iowa Source · since 2013-07-01$80.22——Plans must pay at least this—
3Pennsylvania Source · since 2009-03-31$78.03——Plans negotiate; applies out of network—
24Utah Source · since 2026-07-01$36.45——Plans negotiate; applies out of network—
25Maryland Source · since 2026-02-01$35.89——Not classified—
26Delaware Source · since 2024-01-01$35.83——Plans negotiate; applies out of network—
48California Source · since 2026-10-01$19.49——Plans negotiate; applies out of network—
49Florida Source · since 2026-01-01$17.55——Plans negotiate; applies out of network—
See all 49 states for 86821 — start free

41 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 86821 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 86821?

It depends on the state. Of the 49 states with a published fee-for-service rate, the median is $35.89. Arkansas pays the most ($80.63) and Florida the least ($17.55).

Which state pays the highest Medicaid rate for 86821?

Arkansas, at $80.63, effective 2025-03-26.

Do managed-care plans pay the same rate for 86821?

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.