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Billing code 86972 · Lab & pathology

86972 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $20.78 for 86972 across 21 states, from $2.00 in Louisiana to $129.47 in Kansas.

Data as of Oct 5, 202621 statesEvery rate links to its official source

States publishing
21
National median
$20.78units vary by state
Lowest
$2.00Louisiana
Highest
$129.47Kansas
Answer

What does Medicaid pay for 86972?

21 state Medicaid programs publish a fee-for-service rate for 86972. The national median is $20.78 (units differ between states). Kansas pays the most, $129.47, and Louisiana the least, $2.00, a 64.7x spread.

State ranking

86972 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 21 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Kansas Source · since 2023-07-01$129.47——Plans must pay at least this—
2Mississippi Source · since 2025-07-01$126.55——Plans must pay at least this—
3Missouri Source · since 2021-01-01$119.32——Plans negotiate; applies out of network—
10Arkansas Source · since 2025-03-26$24.00——Not classified—
11Nevada Source · since 2017-01-01$20.78——Plans negotiate; applies out of network—
12Ohio Source · since 2018-01-01$17.56——Plans negotiate; applies out of network—
20Florida Source · since 2026-01-01$4.42——Plans negotiate; applies out of network—
21Louisiana Source · since 2012-07-01$2.00——Plans must pay at least this—
See all 21 states for 86972 — start free

13 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 86972 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 86972?

It depends on the state. Of the 21 states with a published fee-for-service rate, the median is $20.78. Kansas pays the most ($129.47) and Louisiana the least ($2.00).

Which state pays the highest Medicaid rate for 86972?

Kansas, at $129.47, effective 2023-07-01.

Do managed-care plans pay the same rate for 86972?

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.