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81001 Medicaid reimbursement rates by state

Clinical lab tests. 42 state Medicaid programs publish a fee-for-service rate for 81001 at the physician psychologist level. Rates run from $1.55 in Florida to $4.52 in Arkansas, with a median of $3.01.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
42
Median rate
$3.01units vary by state
Highest
$4.52Arkansas
Medicare (non-facility)
—not on the physician fee schedule

81001 rate in every state

One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$4.52since 2025-06-04——Not classified—Arkansas Medicaid Certified Nurse-Midwif
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$4.50since 2014-10-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$3.99since 2017-01-01——Plans negotiate; applies out of network—Lab Max Allowable (in Zipped 2017 Fee Sc
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$3.91since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Clinical Pharm
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$3.80since 2023-07-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$3.54since 2026-09-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$3.42since 2021-11-17——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$3.17since 2020-01-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$3.17since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$3.17since 2020-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service)$3.17since 2025-04-01unit—Plans negotiate; applies out of network—eMedNY Physician Fee Schedule Sect 2 (Me
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$3.17since 2020-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$3.17since 2020-01-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical4.csv
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$3.17since 2020-01-01——Plans negotiate; applies out of network—KY Medicaid Clinical Lab fee schedule (2
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$3.17since 2023-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$3.17since 2020-01-01——Not classified—MaineCare Fee Schedule (MaineCare UCR, H
MontanaIndependent (non-agency) provider · Montana Medicaid and HMK Plus (fee-for-service)$3.16since 2020-01-01——Not classified—Montana Healthcare Programs fee schedule
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$3.16since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Laboratory and Radiol
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$3.12since 2026-02-01——Not classified—Maryland Medicaid Medical Laboratory Fee
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$3.09since 2025-01-01——Not classified—Vermont Medicaid Fee Schedule - CPT Code
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$3.02since 2015-01-01——Not classified—CMAP fee schedule: Lab October 2026
PennsylvaniaRegistered nurse (RN) · Pennsylvania Medical Assistance (fee-for-service)$3.00since 2019-01-14——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$2.86since 2010-01-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
ArizonaClinical nurse specialist · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$2.85since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Clinical
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$2.85since 2026-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Independent L
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$2.85since 2022-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, May 2023
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$2.85since 2023-04-01——Plans negotiate; applies out of network—BMS CY 2023 Clinical Lab Fee Schedule (a
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$2.82since 2024-01-01——Plans must pay at least this—SoonerCare Title XIX Fee Schedule
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$2.80since 2024-09-01——Plans negotiate; applies out of network—Rates for Clinical Laboratory Services (
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$2.77since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$2.74since 2025-09-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$2.74since 2025-01-01——Plans negotiate; applies out of network—2026 Fee Schedule - Covered Procedures R
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$2.64since 2026-07-01——Not classified—Clinical Diagnostic Laboratory Test (CDL
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$2.62since 2023-01-01——Plans negotiate; applies out of network—MDHHS Child and Adolescent Health Center
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$2.54since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$2.54since 2026-01-01——Plans negotiate; applies out of network—HCA Kidney centers fee schedule (kidneyc
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$2.54since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$2.47since 2024-07-01——Not classified—SCDHHS Base Physician Fee Schedule (sche
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$2.38since 2021-01-01——Plans negotiate; applies out of network—ODM laboratory services payment schedule
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$2.21since 2026-04-10——Not classified—Laboratory and Radiology Fee Schedule (R
NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$2.16since 2017-01-01——Plans negotiate; applies out of network—Provider Type 43, Laboratory, Pathology
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$1.55since 2026-01-01——Plans negotiate; applies out of network—Practitioner Laboratory Fee Schedule (20

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 with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Frequently asked questions

What does Medicaid pay for 81001?

It depends on the state. Of the 42 states with a published fee-for-service rate, the median is $3.01. Arkansas pays the most ($4.52) and Florida the least ($1.55).

Which state pays the highest Medicaid rate for 81001?

Arkansas, at $4.52, effective 2025-06-04.

Do managed-care plans pay the same rate for 81001?

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 table shows the rule for each state, cited to the contract or statute.

Related Lab & pathology codes

Track 81001 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
Medicaid rates by state