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Billing code 88388 · Lab & pathology

88388 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $17.11 for 88388 across 9 states, from $0.368 in Arizona to $25.61 in Arkansas.

Data as of Oct 5, 20269 statesEvery rate links to its official source

States publishing
9
National median
$17.11units vary by state
Lowest
$0.368Arizona
Highest
$25.61Arkansas
Answer

What does Medicaid pay for 88388?

9 state Medicaid programs publish a fee-for-service rate for 88388. The national median is $17.11 (units differ between states). Arkansas pays the most, $25.61, and Arizona the least, $0.368 per P, a 69.6x spread.

State ranking

88388 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 9 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Arkansas Source · since 2025-06-13$25.61——Not classified—
2New Mexico Source · since 2023-07-01$22.37——Plans must pay at least this—
3Maryland Source · since 2026-02-01$20.77——Not classified—
5Massachusetts Source · since 2026-10-01$17.11——Plans negotiate; applies out of network—
8Colorado Source · since 2024-07-01$13.04——Plans negotiate; applies out of network—
9Arizona Source · since 2024-10-01$0.368P—Plans negotiate; applies out of network—
See all 9 states for 88388 — start free

3 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 88388 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
Guide

How to read this table

  • Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for 88388, so the order is by published amount and is not a like-for-like rank.
  • Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 9 of the 9 states list more than one rate for 88388, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
  • Unit. Of the 9 states, 1 publish 88388 per p, and 8 schedules print no unit at all (a flat amount per service).
  • Per hour. 88388 is not billed in time units in these states, so no hourly figure is shown.
  • Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
  • % of Medicare. No Medicare physician fee schedule amount is on file for 88388, so there is no percentage.
  • Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Context

Why 88388 rates differ between states

Published rates for 88388 run from $0.368 in Arizona to $25.61 in Arkansas. The two publish it in different units (no unit printed versus P), so part of that gap is the unit rather than the price. Half the states pay more than the median of $17.11 and half pay less. The usual reasons for a spread like this in lab & pathology rates:

  • Fees for newer molecular and genetic tests are often set case by case, so fewer states publish them and the published amounts spread widely.
  • Pathology services with an interpretation have professional and technical components that states price separately.
  • Some states bundle certain tests into panels or into facility payments, so the separately billable amount differs.

Timing matters too. 3 states set the current rate for 88388 in 2026 or later, while 1 state still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.

Managed care

What managed-care plans pay for 88388

No managed-care plan publishes what it pays for 88388. What is public is the rule each state's plan contracts set, and that rule decides how much the published rate matters when you contract with a plan.

In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 6 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 2 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (6 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.
  • Plans must pay at least the published rate (1 state). The published rate is your floor. Negotiate up from it, and if a plan pays less, the contract provision is the basis for a payment dispute.

Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example Arkansas managed care.

Billing

Units and billing for 88388

88388 is a CPT pathology and laboratory code in the lab & pathology line, billed mostly by independent laboratories, hospital labs and pathology groups. Laboratory codes are paid per test; a panel is paid as one code, not as the sum of its tests. Pathology codes with an interpretation can be split into professional and technical components.

Pathology interpretation can be billed with modifier 26 when the laboratory and the pathologist bill separately. Laboratory tests are billed per test, and a panel is paid as a single code rather than as the sum of its component tests.

Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.

FAQ

Frequently asked questions

What does Medicaid pay for 88388?

It depends on the state. Of the 9 states with a published fee-for-service rate, the median is $17.11. Arkansas pays the most ($25.61) and Arizona the least ($0.368 per P).

Which state pays the highest Medicaid rate for 88388?

Arkansas, at $25.61, effective 2025-06-13.

Which state pays the lowest Medicaid rate for 88388?

Arizona, at $0.368 per P, effective 2024-10-01. It publishes the code in a different unit from Arkansas, so compare per unit with care.

What unit is 88388 billed in?

Of the 9 states, 1 publish 88388 per p, and 8 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for 88388?

Not necessarily. In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 6 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 2 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.