81457 Medicaid reimbursement rates by state
Clinical lab tests. 24 state Medicaid programs publish a fee-for-service rate for 81457 at the physician psychologist level. Rates run from $54.64 in Arkansas to $4,550.00 in North Carolina, with a median of $793.51.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 24
- Median rate
- $793.51units vary by state
- Highest
- $4,550.00North Carolina
- Medicare (non-facility)
- —not on the physician fee schedule
81457 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.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $4,550.00⚠ over 3× mediansince 2025-10-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Laboratory' - |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $2,125.85since 2024-01-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $968.61since 2026-03-13 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $896.87since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Clinical |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $896.87since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $896.87since 2025-01-01 | — | — | 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) | $896.87since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Clinical Lab fee schedule (2 |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $894.21since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $807.18since 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) | $807.18since 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) | $807.18since 2025-04-01 | — | — | Plans negotiate; applies out of network | — | BMS CY 2025 Clinical Lab Fee Schedule |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $797.76since 2026-01-01 | — | — | 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) | $789.25since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file cptmedical4.csv |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $774.89since 2025-09-01 | — | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $742.61since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Clinical Laboratory Fee Schedule, |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $717.50since 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 | $717.50since 2026-01-01 | — | — | Plans may pay no more | — | HCA Physician-related services fee sched |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $717.50since 2025-04-01 | — | — | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $672.65since 2025-04-01 | — | — | Plans negotiate; applies out of network | — | ODM laboratory services payment schedule |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $627.81since 2025-01-01 | — | — | Not classified | — | CMAP fee schedule: Lab October 2026 |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $588.02since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service CPT |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $502.35since 2024-05-28 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $484.31since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Independent Laboratory Fee Schedule (202 |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $54.64since 2025-03-26 | — | — | Not classified | — | Arkansas Medicaid Independent Laboratory |
Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 81457?
It depends on the state. Of the 24 states with a published fee-for-service rate, the median is $793.51. North Carolina pays the most ($4,550.00) and Arkansas the least ($54.64).
Which state pays the highest Medicaid rate for 81457?
North Carolina, at $4,550.00, effective 2025-10-01.
Do managed-care plans pay the same rate for 81457?
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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Track 81457 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.