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81314 Medicaid reimbursement rates by state

Clinical lab tests. 28 state Medicaid programs publish a fee-for-service rate for 81314 at the independent level. Rates run from $80.65 in Connecticut to $355.87 in Texas, with a median of $282.54.

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

States publishing
28
Median rate
$282.54units vary by state
Highest
$355.87Texas
Medicare (non-facility)
—not on the physician fee schedule

81314 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
TexasIndependent (non-agency) provider · Texas Medicaid (fee-for-service, TMHP)$355.87since 2019-07-04——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Labor
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$329.51since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Clinical
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$329.51since 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)$329.51since 2024-07-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$329.51since 2018-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$329.51since 2016-01-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$329.51since 2020-01-01——Plans negotiate; applies out of network—KY Medicaid Clinical Lab fee schedule (2
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$329.51since 2025-03-26——Not classified—Arkansas Medicaid Independent Laboratory
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$329.51since 2024-11-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$296.56since 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)$296.56since 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)$293.09since 2024-01-01——Plans must pay at least this—SoonerCare Title XIX Fee Schedule
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$292.00since 2017-01-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical4.csv
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$290.59since 2024-09-01——Plans negotiate; applies out of network—Rates for Clinical Laboratory Services (
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$274.48since 2026-07-01——Not classified—Clinical Diagnostic Laboratory Test (CDL
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$272.84since 2023-01-01——Plans negotiate; applies out of network—MDHHS Clinical Laboratory Fee Schedule,
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$263.61since 2017-01-01——Plans negotiate; applies out of network—Lab Max Allowable (in Zipped 2017 Fee Sc
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$263.61since 2021-12-01——Not classified—NJMMIS Procedure Master Listing Outpatie
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$263.61since 2016-07-01——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$263.61since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$263.60since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$261.96since 2026-02-01——Not classified—Maryland Medicaid Medical Laboratory Fee
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$247.13since 2019-04-01——Plans negotiate; applies out of network—ODM laboratory services payment schedule
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$224.43since 2024-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$207.26since 2016-01-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$199.69since 2020-05-29——Plans negotiate; applies out of network—eMedNY NYS Medicaid Laboratory Fee Sched
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$86.40since 2026-01-01——Plans negotiate; applies out of network—Practitioner Laboratory Fee Schedule (20
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$80.65since 2016-01-01——Not classified—CMAP fee schedule: Lab October 2026

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 81314?

It depends on the state. Of the 28 states with a published fee-for-service rate, the median is $282.54. Texas pays the most ($355.87) and Connecticut the least ($80.65).

Which state pays the highest Medicaid rate for 81314?

Texas, at $355.87, effective 2019-07-04.

Do managed-care plans pay the same rate for 81314?

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

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