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Billing code 87003 · Lab & pathology

87003 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $16.41 for 87003 across 44 states, from $3.51 in Virginia to $23.91 in Iowa.

Data as of Oct 5, 202644 statesEvery rate links to its official source

States publishing
44
National median
$16.41units vary by state
Lowest
$3.51Virginia
Highest
$23.91Iowa
Answer

What does Medicaid pay for 87003?

44 state Medicaid programs publish a fee-for-service rate for 87003. The national median is $16.41 (units differ between states). Iowa pays the most, $23.91, and Virginia the least, $3.51, a 6.8x spread.

State ranking

87003 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 44 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Iowa Source · since 2013-07-01$23.91——Plans must pay at least this—
2Kansas Source · since 1996-01-01$23.26——Plans must pay at least this—
3Georgia Source · since 2018-10-01$21.17——Plans negotiate; applies out of network—
22Vermont Source · since 2025-01-01$16.42——Not classified—
23Illinois Source · since 2024-04-01$16.39——Plans negotiate; applies out of network—
24Connecticut Source · since 2015-01-01$16.08——Not classified—
43Rhode Island Source · since 2003-01-01$9.76——Plans negotiate; applies out of network—
44Virginia Source · since 2014-07-01$3.51——Plans negotiate; applies out of network—
See all 44 states for 87003 — start free

36 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 87003 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 87003?

It depends on the state. Of the 44 states with a published fee-for-service rate, the median is $16.41. Iowa pays the most ($23.91) and Virginia the least ($3.51).

Which state pays the highest Medicaid rate for 87003?

Iowa, at $23.91, effective 2013-07-01.

Do managed-care plans pay the same rate for 87003?

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.