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81351 Medicaid reimbursement rates by state

Clinical lab tests. 26 state Medicaid programs publish a fee-for-service rate for 81351 at the physician psychologist level. Rates run from $188.82 in Colorado to $693.19 in Texas, with a median of $545.57.

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

States publishing
26
Median rate
$545.57units vary by state
Highest
$693.19Texas
Medicare (non-facility)
—not on the physician fee schedule

81351 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)$693.19since 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)$641.85since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Clinical
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$641.85since 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)$641.85since 2021-01-01——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)$641.85since 2021-01-01——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)$641.85since 2025-03-26——Not classified—Arkansas Medicaid Independent Laboratory
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$609.76since 2021-01-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$584.08since 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)$577.67since 2026-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Independent L
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$570.92since 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)$566.03since 2024-09-01——Plans negotiate; applies out of network—Rates for Clinical Laboratory Services (
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$564.82since 2021-01-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical4.csv
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$545.57since 2025-07-01——Plans must pay at least this—Louisiana Medicaid Laboratory and Radiol
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$545.57since 2021-01-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$531.46since 2023-01-01——Plans negotiate; applies out of network—MDHHS Clinical Laboratory Fee Schedule,
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$513.48since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$513.48since 2021-01-01——Plans negotiate; applies out of network—Lab Max Allowable_ (003) (in Zipped Fee
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$513.48since 2021-12-01——Not classified—NJMMIS Procedure Master Listing Outpatie
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$513.48since 2021-01-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$513.48since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$481.39since 2021-04-01——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)$437.17since 2024-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$388.96since 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)$346.60since 2026-01-01——Plans negotiate; applies out of network—Independent Laboratory Fee Schedule (202
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$201.48since 2021-01-01——Not classified—CMAP fee schedule: Lab October 2026
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$188.82since 2026-07-01——Not classified—Clinical Diagnostic Laboratory Test (CDL

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 81351?

It depends on the state. Of the 26 states with a published fee-for-service rate, the median is $545.57. Texas pays the most ($693.19) and Colorado the least ($188.82).

Which state pays the highest Medicaid rate for 81351?

Texas, at $693.19, effective 2019-07-04.

Do managed-care plans pay the same rate for 81351?

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.

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