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Billing code 81355 · Lab & pathology

81355 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $79.38 for 81355 across 25 states, from $13.50 in Arizona to $105.84 in New Mexico.

Data as of Oct 5, 202625 statesEvery rate links to its official source

States publishing
25
National median
$79.38units vary by state
Lowest
$13.50Arizona
Highest
$105.84New Mexico
Answer

What does Medicaid pay for 81355?

25 state Medicaid programs publish a fee-for-service rate for 81355. The national median is $79.38 (units differ between states). New Mexico pays the most, $105.84, and Arizona the least, $13.50 per A, a 7.8x spread.

State ranking

81355 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 25 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1New Mexico Source · since 2024-11-01$105.84——Plans must pay at least this—
2Texas Source · since 2019-07-04$95.25——Plans negotiate; applies out of network—
3Montana Source · since 2018-07-01$88.20——Not classified—
12Mississippi Source · since 2022-07-01$79.38——Plans must pay at least this—
13Wyoming Source · since 2025-04-01$79.38——Not classified—
14Virginia Source · since 2013-05-01$79.03——Plans negotiate; applies out of network—
24Florida Source · since 2026-01-01$47.63——Plans negotiate; applies out of network—
25Arizona Source · since 2021-10-01$13.50A—Plans negotiate; applies out of network—
See all 25 states for 81355 — start free

17 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 81355 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 81355?

It depends on the state. Of the 25 states with a published fee-for-service rate, the median is $79.38. New Mexico pays the most ($105.84) and Arizona the least ($13.50 per A).

Which state pays the highest Medicaid rate for 81355?

New Mexico, at $105.84, effective 2024-11-01.

Do managed-care plans pay the same rate for 81355?

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.