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Billing code 87109 · Lab & pathology

87109 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $13.85 for 87109 across 50 states, from $4.09 in Iowa to $21.97 in Arkansas.

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

States publishing
50
National median
$13.85units vary by state
Lowest
$4.09Iowa
Highest
$21.97Arkansas
Answer

What does Medicaid pay for 87109?

50 state Medicaid programs publish a fee-for-service rate for 87109. The national median is $13.85 (units differ between states). Arkansas pays the most, $21.97, and Iowa the least, $4.09, a 5.4x spread.

State ranking

87109 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$21.97——Not classified—
2Georgia Source · since 2018-10-01$19.35——Plans negotiate; applies out of network—
3North Carolina Source · since 2025-10-01$18.98——Plans must pay at least this—
25Mississippi Source · since 2022-07-01$13.85——Plans must pay at least this—
26West Virginia Source · since 2023-04-01$13.85——Plans negotiate; applies out of network—
27Wyoming Source · since 2025-09-01$13.85——Not classified—
49Rhode Island Source · since 2003-01-01$7.33——Plans negotiate; applies out of network—
50Iowa Source · since 2013-07-01$4.09——Plans must pay at least this—
See all 50 states for 87109 — 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 87109 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 87109?

It depends on the state. Of the 50 states with a published fee-for-service rate, the median is $13.85. Arkansas pays the most ($21.97) and Iowa the least ($4.09).

Which state pays the highest Medicaid rate for 87109?

Arkansas, at $21.97, effective 2025-03-26.

Do managed-care plans pay the same rate for 87109?

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.