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Billing code 87497 · Lab & pathology

87497 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $39.37 for 87497 across 50 states, from $20.56 in Florida to $61.17 in Arkansas.

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

States publishing
50
National median
$39.37units vary by state
Lowest
$20.56Florida
Highest
$61.17Arkansas
Answer

What does Medicaid pay for 87497?

50 state Medicaid programs publish a fee-for-service rate for 87497. The national median is $39.37 (units differ between states). Arkansas pays the most, $61.17, and Florida the least, $20.56, a 3.0x spread.

State ranking

87497 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$61.17——Not classified—
2Iowa Source · since 2013-07-01$60.87——Plans must pay at least this—
3Georgia Source · since 2018-10-01$53.87——Plans negotiate; applies out of network—
25North Carolina Source · since 2025-10-01$40.17——Plans must pay at least this—
26Arizona Source · since 2026-10-01$38.56——Plans negotiate; applies out of network—
27Missouri Source · since 2026-07-01$38.56——Plans negotiate; applies out of network—
49New York Source · since 2020-05-29$28.85——Plans negotiate; applies out of network—
50Florida Source · since 2026-01-01$20.56——Plans negotiate; applies out of network—
See all 50 states for 87497 — 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 87497 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 87497?

It depends on the state. Of the 50 states with a published fee-for-service rate, the median is $39.37. Arkansas pays the most ($61.17) and Florida the least ($20.56).

Which state pays the highest Medicaid rate for 87497?

Arkansas, at $61.17, effective 2025-03-26.

Do managed-care plans pay the same rate for 87497?

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.