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Billing code 81332 · Lab & pathology

81332 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $41.69 for 81332 across 36 states, from $13.50 in Arizona to $77.28 in Arkansas.

Data as of Oct 5, 202636 statesEvery rate links to its official source

States publishing
36
National median
$41.69units vary by state
Lowest
$13.50Arizona
Highest
$77.28Arkansas
Answer

What does Medicaid pay for 81332?

36 state Medicaid programs publish a fee-for-service rate for 81332. The national median is $41.69 (units differ between states). Arkansas pays the most, $77.28, and Arizona the least, $13.50 per A, a 5.7x spread.

State ranking

81332 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 36 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Arkansas Source · since 2025-03-26$77.28——Not classified—
2New Mexico Source · since 2024-11-01$52.38——Plans must pay at least this—
3Kansas Source · since 2014-04-01$50.62——Plans must pay at least this—
18Maine Source · since 2016-07-01$41.69——Not classified—
19Connecticut Source · since 2015-01-01$41.68——Not classified—
20Georgia Source · since 2017-01-01$40.00——Plans negotiate; applies out of network—
35Florida Source · since 2026-01-01$24.61——Plans negotiate; applies out of network—
36Arizona Source · since 2021-10-01$13.50A—Plans negotiate; applies out of network—
See all 36 states for 81332 — start free

28 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 81332 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
Guide

How to read this table

  • Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for 81332, so the order is by published amount and is not a like-for-like rank.
  • Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 12 of the 36 states list more than one rate for 81332, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
  • Unit. Of the 36 states, 1 publish 81332 per unit and 1 per a, and 34 schedules print no unit at all (a flat amount per service).
  • Per hour. 81332 is not billed in time units in these states, so no hourly figure is shown.
  • Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
  • % of Medicare. No Medicare physician fee schedule amount is on file for 81332, so there is no percentage.
  • Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Context

Why 81332 rates differ between states

Published rates for 81332 run from $13.50 in Arizona to $77.28 in Arkansas. The two publish it in different units (no unit printed versus A), so part of that gap is the unit rather than the price. Half the states pay more than the median of $41.69 and half pay less. The usual reasons for a spread like this in lab & pathology rates:

  • Fees for newer molecular and genetic tests are often set case by case, so fewer states publish them and the published amounts spread widely.
  • Pathology services with an interpretation have professional and technical components that states price separately.
  • Some states bundle certain tests into panels or into facility payments, so the separately billable amount differs.

Timing matters too. 7 states set the current rate for 81332 in 2026 or later, while 15 states still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.

Managed care

What managed-care plans pay for 81332

Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For 81332, the public signal is the rule each state sets for its plans, recorded on each rate above.

In 6 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 18 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 12 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (18 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.
  • Plans must pay at least the published rate (6 states). The published rate is your floor. Negotiate up from it, and if a plan pays less, the contract provision is the basis for a payment dispute.

Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example Arkansas managed care.

Billing

Units and billing for 81332

81332 is a CPT pathology and laboratory code in the lab & pathology line, billed mostly by independent laboratories, hospital labs and pathology groups. Laboratory codes are paid per test; a panel is paid as one code, not as the sum of its tests. Pathology codes with an interpretation can be split into professional and technical components.

Laboratory tests are billed per test, and a panel is paid as a single code rather than as the sum of its component tests. Pathology interpretation can be billed with modifier 26 when the laboratory and the pathologist bill separately.

Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.

FAQ

Frequently asked questions

What does Medicaid pay for 81332?

It depends on the state. Of the 36 states with a published fee-for-service rate, the median is $41.69. Arkansas pays the most ($77.28) and Arizona the least ($13.50 per A).

Which state pays the highest Medicaid rate for 81332?

Arkansas, at $77.28, effective 2025-03-26.

Which state pays the lowest Medicaid rate for 81332?

Arizona, at $13.50 per A, effective 2021-10-01. It publishes the code in a different unit from Arkansas, so compare per unit with care.

What unit is 81332 billed in?

Of the 36 states, 1 publish 81332 per unit and 1 per a, and 34 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for 81332?

Not necessarily. In 6 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 18 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 12 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.