81287 Medicaid reimbursement rates by state
Clinical lab tests. 28 state Medicaid programs publish a fee-for-service rate for 81287 at the independent level. Rates run from $13.50 in Arizona to $134.61 in Texas, with a median of $108.87.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 28
- Median rate
- $108.87units vary by state
- Highest
- $134.61Texas
- Medicare (non-facility)
- —not on the physician fee schedule
81287 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.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| TexasIndependent (non-agency) provider · Texas Medicaid (fee-for-service, TMHP) | $134.61since 2019-07-04 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Labor |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $124.64since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $124.64since 2018-01-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $124.64since 2020-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Clinical Lab fee schedule (2 |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $124.64since 2024-11-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service CPT |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service | $124.64since 2026-06-01 | — | — | Plans negotiate; applies out of network | — | Medicaid Fee-For-Service (FFS) Fee Sched |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $124.64since 2019-12-01 | — | — | Not classified | — | South Dakota Medicaid Laboratory fee sch |
| North DakotaAny qualified provider (rate does not vary by provider) · North Dakota Medicaid (fee-for-service) | $124.64since 2025-01-01 | — | — | Not classified | — | ND Medicaid Professional Services Fee Sc |
| MontanaIndependent (non-agency) provider · Montana Medicaid and HMK Plus (fee-for-service) | $124.63since 2018-07-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $113.42since 2025-10-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Laboratory' - |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $112.18since 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) | $112.18since 2022-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, May 2023 |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $110.87since 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) | $109.92since 2024-09-01 | — | — | Plans negotiate; applies out of network | — | Rates for Clinical Laboratory Services ( |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $107.81since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $107.69since 2025-09-01 | — | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $99.71since 2025-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $99.09since 2026-02-01 | — | — | Not classified | — | Maryland Medicaid Medical Laboratory Fee |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $97.22since 2024-07-01 | — | — | Not classified | — | SCDHHS Independent Lab and Radiology Fee |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $93.48since 2019-04-01 | — | — | Plans negotiate; applies out of network | — | ODM laboratory services payment schedule |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $87.25since 2018-01-01 | — | — | Not classified | — | CMAP fee schedule: Lab October 2026 |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $84.89since 2024-04-01 | — | — | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $83.09since 2016-01-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $83.01since 2014-06-23 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $67.30since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Independent Laboratory Fee Schedule (202 |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $58.16since 2016-07-01 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $16.40since 2014-01-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $13.50since 2021-10-01 | A | — | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
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 81287?
It depends on the state. Of the 28 states with a published fee-for-service rate, the median is $108.87. Texas pays the most ($134.61) and Arizona the least ($13.50 per A).
Which state pays the highest Medicaid rate for 81287?
Texas, at $134.61, effective 2019-07-04.
Do managed-care plans pay the same rate for 81287?
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
80051Clinical lab tests · 50 states80053Clinical lab tests · 50 states80061Clinical lab tests · 50 states80069Clinical lab tests · 50 states80076Clinical lab tests · 50 states80150Clinical lab tests · 50 states80156Clinical lab tests · 50 states80157Clinical lab tests · 50 states80158Clinical lab tests · 50 states80159Clinical lab tests · 50 states80162Clinical lab tests · 50 states80164Clinical lab tests · 50 states
Track 81287 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.