89322 Medicaid reimbursement rate by state (2026)
Clinical lab tests. Medicaid pays a median of $15.20 for 89322 across 22 states, from $12.40 in New Jersey to $22.37 in Arkansas.
- States publishing
- 22
- National median
- $15.20units vary by state
- Lowest
- $12.40New Jersey
- Highest
- $22.37Arkansas
What does Medicaid pay for 89322?
22 state Medicaid programs publish a fee-for-service rate for 89322. The national median is $15.20 (units differ between states). Arkansas pays the most, $22.37, and New Jersey the least, $12.40, a 1.8x spread.
89322 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 22 states with every variant, modifier and effective date.
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 89322, 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. 8 of the 22 states list more than one rate for 89322, 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. None of the 22 schedules prints a separate unit for 89322, so each amount is a flat payment for one service as the code defines it.
- Per hour. 89322 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 89322, 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.
Why 89322 rates differ between states
Published rates for 89322 run from $12.40 in New Jersey to $22.37 in Arkansas, a 1.8x gap in the same unit. Half the states pay more than the median of $15.20 and half pay less. The usual reasons for a spread like this in lab & pathology rates:
- Many states set clinical laboratory fees with reference to the Medicare Clinical Laboratory Fee Schedule, but at different percentages and from different update years.
- 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. 6 states set the current rate for 89322 in 2026 or later, while 7 states 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.
What managed-care plans pay for 89322
Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For 89322, the public signal is the rule each state sets for its plans, recorded on each rate above.
In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 12 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 8 states is not classified yet.
- Plans negotiate; the published rate applies out of network (12 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 (2 states). 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.
Units and billing for 89322
89322 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.
Frequently asked questions
What does Medicaid pay for 89322?
It depends on the state. Of the 22 states with a published fee-for-service rate, the median is $15.20. Arkansas pays the most ($22.37) and New Jersey the least ($12.40).
Which state pays the highest Medicaid rate for 89322?
Arkansas, at $22.37, effective 2025-03-26.
Which state pays the lowest Medicaid rate for 89322?
New Jersey, at $12.40, effective 2025-01-01.
What unit is 89322 billed in?
None of the 22 schedules prints a separate unit for 89322, so each amount is a flat payment for one service as the code defines it.
Do managed-care plans pay the same rate for 89322?
Not necessarily. In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 12 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 8 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.