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81520 Medicaid reimbursement rates by state

Clinical lab tests. 33 state Medicaid programs publish a fee-for-service rate for 81520 at the physician psychologist level. Rates run from $1,355.52 in Florida to $3,099.02 in Arkansas, with a median of $2,259.19.

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

States publishing
33
Median rate
$2,259.19units vary by state
Highest
$3,099.02Arkansas
Medicare (non-facility)
—not on the physician fee schedule

81520 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
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$3,099.02since 2025-03-26——Not classified—Arkansas Medicaid Independent Laboratory
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$2,711.02since 2019-07-04——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$2,634.17since 2018-05-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$2,510.21since 2022-07-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$2,510.21since 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)$2,510.21since 2020-01-01——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)$2,510.21since 2020-01-01——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)$2,510.21since 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)$2,510.21since 2024-11-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$2,510.21since 2026-06-01——Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched
MontanaIndependent (non-agency) provider · Montana Medicaid and HMK Plus (fee-for-service)$2,510.20since 2020-01-01——Not classified—Montana Healthcare Programs fee schedule
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$2,502.76since 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$2,460.01since 2024-01-01——Plans negotiate; applies out of network—DMAP 2024 Physician Fee Schedule
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$2,284.29since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Laboratory' -
ArizonaClinical nurse specialist · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$2,259.19since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Clinical
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$2,259.19since 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)$2,259.19since 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)$2,259.19since 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)$2,232.80since 2024-01-01——Plans must pay at least this—SoonerCare Title XIX Fee Schedule
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$2,231.29since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$2,213.69since 2024-09-01——Plans negotiate; applies out of network—Rates for Clinical Laboratory Services (
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$2,169.31since 2018-01-01——Not classified—MaineCare Fee Schedule (MaineCare UCR, H
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$2,091.00since 2026-07-01——Not classified—Clinical Diagnostic Laboratory Test (CDL
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$2,078.45since 2023-01-01——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)$2,008.17since 2020-12-01——Not classified—NJMMIS Procedure Master Listing Outpatie
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$2,008.17since 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)$2,008.17since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$1,995.62since 2026-02-01——Not classified—Maryland Medicaid Medical Laboratory Fee
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$1,882.66since 2021-04-01——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)$1,757.15since 2021-01-01——Not classified—CMAP fee schedule: Lab October 2026
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$1,709.71since 2024-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$1,549.51since 2018-01-01——Plans negotiate; applies out of network—Provider Type 43, Laboratory, Pathology
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$1,355.52since 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 81520?

It depends on the state. Of the 33 states with a published fee-for-service rate, the median is $2,259.19. Arkansas pays the most ($3,099.02) and Florida the least ($1,355.52).

Which state pays the highest Medicaid rate for 81520?

Arkansas, at $3,099.02, effective 2025-03-26.

Do managed-care plans pay the same rate for 81520?

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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