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Billing code 87516 · Lab & pathology

87516 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $31.58 for 87516 across 49 states, from $16.84 in Florida to $50.12 in Arkansas.

Data as of Oct 5, 202649 statesEvery rate links to its official source

States publishing
49
National median
$31.58units vary by state
Lowest
$16.84Florida
Highest
$50.12Arkansas
Answer

What does Medicaid pay for 87516?

49 state Medicaid programs publish a fee-for-service rate for 87516. The national median is $31.58 (units differ between states). Arkansas pays the most, $50.12, and Florida the least, $16.84, a 3.0x spread.

State ranking

87516 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 49 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Arkansas Source · since 2025-03-26$50.12——Not classified—
2Iowa Source · since 2013-07-01$49.86——Plans must pay at least this—
3Wyoming Source · since 2021-01-01$43.04——Not classified—
24Arizona Source · since 2026-10-01$31.58——Plans negotiate; applies out of network—
25Missouri Source · since 2026-07-01$31.58——Plans negotiate; applies out of network—
26Mississippi Source · since 2022-07-01$31.58——Plans must pay at least this—
48New York Source · since 2020-05-29$21.64——Plans negotiate; applies out of network—
49Florida Source · since 2026-01-01$16.84——Plans negotiate; applies out of network—
See all 49 states for 87516 — start free

41 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 87516 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 87516?

It depends on the state. Of the 49 states with a published fee-for-service rate, the median is $31.58. Arkansas pays the most ($50.12) and Florida the least ($16.84).

Which state pays the highest Medicaid rate for 87516?

Arkansas, at $50.12, effective 2025-03-26.

Do managed-care plans pay the same rate for 87516?

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.