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81410 Medicaid reimbursement rates by state

Clinical lab tests. 24 state Medicaid programs publish a fee-for-service rate for 81410 at the independent level. Rates run from $272.16 in Florida to $641.86 in Georgia, with a median of $446.39.

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

States publishing
24
Median rate
$446.39units vary by state
Highest
$641.86Georgia
Medicare (non-facility)
—not on the physician fee schedule

81410 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
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$641.86since 2025-04-01——Plans negotiate; applies out of network—Lab Max Allowable April 2025 (in Zipped
TexasIndependent (non-agency) provider · Texas Medicaid (fee-for-service, TMHP)$544.32since 2019-07-04——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Labor
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$519.34since 2015-01-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$504.00since 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)$504.00since 2018-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$504.00since 2018-01-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical4.csv
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$504.00since 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)$504.00since 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)$453.60since 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)$453.60since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$453.60since 2023-04-01——Plans negotiate; applies out of network—BMS CY 2023 Clinical Lab Fee Schedule (a
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$448.30since 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)$444.47since 2024-09-01——Plans negotiate; applies out of network—Rates for Clinical Laboratory Services (
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$435.46since 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)$403.20since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$403.20since 2026-01-01——Plans may pay no more—HCA Physician-related services fee sched
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$403.20since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$393.12since 2024-12-01——Not classified—SCDHHS Independent Lab and Radiology Fee
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$378.00since 2019-04-01——Plans negotiate; applies out of network—ODM laboratory services payment schedule
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$360.00since 2025-03-26——Not classified—Arkansas Medicaid Independent Laboratory
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$352.80since 2018-01-01——Not classified—CMAP fee schedule: Lab October 2026
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$352.80since 2025-01-01——Not classified—MaineCare Fee Schedule (MaineCare UCR, H
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$343.27since 2024-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$272.16since 2026-01-01——Plans negotiate; applies out of network—Independent Laboratory Fee Schedule (202

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 81410?

It depends on the state. Of the 24 states with a published fee-for-service rate, the median is $446.39. Georgia pays the most ($641.86) and Florida the least ($272.16).

Which state pays the highest Medicaid rate for 81410?

Georgia, at $641.86, effective 2025-04-01.

Do managed-care plans pay the same rate for 81410?

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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