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Billing code 87254 · Lab & pathology

87254 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $17.09 for 87254 across 50 states, from $3.10 in Iowa to $23.47 in New Mexico.

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

States publishing
50
National median
$17.09units vary by state
Lowest
$3.10Iowa
Highest
$23.47New Mexico
Answer

What does Medicaid pay for 87254?

50 state Medicaid programs publish a fee-for-service rate for 87254. The national median is $17.09 (units differ between states). New Mexico pays the most, $23.47, and Iowa the least, $3.10, a 7.6x spread.

State ranking

87254 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
1New Mexico Source · since 2023-07-01$23.47——Plans must pay at least this—
2Texas Source · since 2021-11-17$21.12——Plans negotiate; applies out of network—
3North Carolina Source · since 2025-10-01$20.09——Plans must pay at least this—
25Massachusetts Source · since 2024-09-01$17.25——Plans negotiate; applies out of network—
26New Hampshire Source · since 2025-01-01$16.92——Plans negotiate; applies out of network—
27Idaho Source · since 2025-09-01$16.90——Not classified—
49Virginia Source · since 2015-01-01$3.77——Plans negotiate; applies out of network—
50Iowa Source · since 2013-07-01$3.10——Plans must pay at least this—
See all 50 states for 87254 — 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 87254 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 87254?

It depends on the state. Of the 50 states with a published fee-for-service rate, the median is $17.09. New Mexico pays the most ($23.47) and Iowa the least ($3.10).

Which state pays the highest Medicaid rate for 87254?

New Mexico, at $23.47, effective 2023-07-01.

Do managed-care plans pay the same rate for 87254?

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.