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Billing code 86999 · Lab & pathology

86999 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $30.88 for 86999 across 8 states, from $13.46 in Ohio to $120.00 in District of Columbia.

Data as of Oct 5, 20268 statesEvery rate links to its official source

States publishing
8
National median
$30.88units vary by state
Lowest
$13.46Ohio
Highest
$120.00District of Columbia
Answer

What does Medicaid pay for 86999?

8 state Medicaid programs publish a fee-for-service rate for 86999. The national median is $30.88 (units differ between states). District of Columbia pays the most, $120.00, and Ohio the least, $13.46, a 8.9x spread.

State ranking

86999 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 8 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1District of Columbia Source · since 1999-04-01$120.00——Not classified—
2Wyoming Source · since 2020-02-01$70.00——Not classified—
3Louisiana Source · since 2000-07-01$45.90——Plans must pay at least this—
7South Dakota Source · since 2026-07-01$17.08——Not classified—
8Ohio Source · since 2018-01-01$13.46——Plans negotiate; applies out of network—
See all 8 states for 86999 — start free

3 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 86999 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 86999?

It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $30.88. District of Columbia pays the most ($120.00) and Ohio the least ($13.46).

Which state pays the highest Medicaid rate for 86999?

District of Columbia, at $120.00, effective 1999-04-01.

Do managed-care plans pay the same rate for 86999?

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.