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Billing code 81005 · Lab & pathology

81005 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $2.07 for 81005 across 49 states, from $1.04 in Florida to $3.10 in Arkansas.

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

States publishing
49
National median
$2.07units vary by state
Lowest
$1.04Florida
Highest
$3.10Arkansas
Answer

What does Medicaid pay for 81005?

49 state Medicaid programs publish a fee-for-service rate for 81005. The national median is $2.07 (units differ between states). Arkansas pays the most, $3.10, and Florida the least, $1.04, a 3.0x spread.

State ranking

81005 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 2025-06-04$3.10——Not classified—
2Iowa Source · since 2013-07-01$3.08——Plans must pay at least this—
3Pennsylvania Source · since 2009-04-04$2.99——Plans negotiate; applies out of network—
24Vermont Source · since 2025-01-01$2.12——Not classified—
25Connecticut Source · since 2015-01-01$2.07——Not classified—
26Arizona Source · since 2026-10-01$1.95——Plans negotiate; applies out of network—
48Nevada Source · since 2017-01-01$1.48——Plans negotiate; applies out of network—
49Florida Source · since 2026-01-01$1.04——Plans negotiate; applies out of network—
See all 49 states for 81005 — 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 81005 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 81005?

It depends on the state. Of the 49 states with a published fee-for-service rate, the median is $2.07. Arkansas pays the most ($3.10) and Florida the least ($1.04).

Which state pays the highest Medicaid rate for 81005?

Arkansas, at $3.10, effective 2025-06-04.

Do managed-care plans pay the same rate for 81005?

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.