81535 Medicaid reimbursement rates by state
Clinical lab tests. 12 state Medicaid programs publish a fee-for-service rate for 81535. Rates run from $278.14 in Florida to $579.46 in Kentucky, with a median of $471.68.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 12
- Median rate
- $471.68units vary by state
- Highest
- $579.46Kentucky
- Medicare (non-facility)
- —not on the physician fee schedule
81535 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 |
|---|---|---|---|---|---|---|
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $579.46since 2020-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Clinical Lab fee schedule (2 |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $521.51since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | MO HealthNet fee schedule: Independent L |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $511.01since 2024-09-01 | — | — | Plans negotiate; applies out of network | — | Rates for Clinical Laboratory Services ( |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $492.54since 2016-01-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $482.69since 2026-07-01 | — | — | Not classified | — | Clinical Diagnostic Laboratory Test (CDL |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $479.79since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Clinical Laboratory Fee Schedule, |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $463.57since 2017-01-01 | — | — | Plans negotiate; applies out of network | — | Lab Max Allowable (in Zipped 2017 Fee Sc |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $463.57since 2021-12-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing Outpatie |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $451.98since 2024-07-01 | — | — | Not classified | — | SCDHHS Independent Lab and Radiology Fee |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $405.62since 2016-01-01 | — | — | Not classified | — | CMAP fee schedule: Lab October 2026 |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $394.67since 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) | $278.14since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Practitioner Laboratory Fee Schedule (20 |
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 81535?
It depends on the state. Of the 12 states with a published fee-for-service rate, the median is $471.68. Kentucky pays the most ($579.46) and Florida the least ($278.14).
Which state pays the highest Medicaid rate for 81535?
Kentucky, at $579.46, effective 2020-01-01.
Do managed-care plans pay the same rate for 81535?
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.