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Billing code 81268 · Lab & pathology

81268 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $234.71 for 81268 across 34 states, from $13.50 in Arizona to $302.41 in Kansas.

Data as of Oct 5, 202634 statesEvery rate links to its official source

States publishing
34
National median
$234.71units vary by state
Lowest
$13.50Arizona
Highest
$302.41Kansas
Answer

What does Medicaid pay for 81268?

34 state Medicaid programs publish a fee-for-service rate for 81268. The national median is $234.71 (units differ between states). Kansas pays the most, $302.41, and Arizona the least, $13.50 per A, a 22.4x spread.

State ranking

81268 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 34 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Kansas Source · since 2014-04-01$302.41——Plans must pay at least this—
2Texas Source · since 2021-11-17$281.65——Plans negotiate; applies out of network—
3Montana Source · since 2020-01-01$260.79——Not classified—
17Missouri Source · since 2026-07-01$234.71——Plans negotiate; applies out of network—
18Mississippi Source · since 2022-07-01$234.71——Plans must pay at least this—
19West Virginia Source · since 2023-04-01$234.71——Plans negotiate; applies out of network—
33Georgia Source · since 2017-01-01$98.40——Plans negotiate; applies out of network—
34Arizona Source · since 2021-10-01$13.50A—Plans negotiate; applies out of network—
See all 34 states for 81268 — start free

26 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 81268 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 81268?

It depends on the state. Of the 34 states with a published fee-for-service rate, the median is $234.71. Kansas pays the most ($302.41) and Arizona the least ($13.50 per A).

Which state pays the highest Medicaid rate for 81268?

Kansas, at $302.41, effective 2014-04-01.

Do managed-care plans pay the same rate for 81268?

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.