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Billing code 81540 · Lab & pathology

81540 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $3,341.02 for 81540 across 16 states, from $10.00 in Kansas to $3,750.00 in Montana.

Data as of Oct 5, 202616 statesEvery rate links to its official source

States publishing
16
National median
$3,341.02units vary by state
Lowest
$10.00Kansas
Highest
$3,750.00Montana
Answer

What does Medicaid pay for 81540?

16 state Medicaid programs publish a fee-for-service rate for 81540. The national median is $3,341.02 (units differ between states). Montana pays the most, $3,750.00, and Kansas the least, $10.00, a 375.0x spread.

State ranking

81540 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 16 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Montana Source · since 2022-01-01$3,750.00——Not classified—
2Kentucky Source · since 2020-01-01$3,750.00——Plans negotiate; applies out of network—
3New Mexico Source · since 2024-11-01$3,750.00——Plans must pay at least this—
8Mississippi Source · since 2026-07-01$3,375.00——Plans must pay at least this—
9Massachusetts Source · since 2024-09-01$3,307.03——Plans negotiate; applies out of network—
10Idaho Source · since 2025-09-01$3,240.00——Not classified—
15Florida Source · since 2026-01-01$2,025.00——Plans negotiate; applies out of network—
16Kansas Source · since 2016-01-01$10.00——Plans must pay at least this—
See all 16 states for 81540 — start free

8 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 81540 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 81540?

It depends on the state. Of the 16 states with a published fee-for-service rate, the median is $3,341.02. Montana pays the most ($3,750.00) and Kansas the least ($10.00).

Which state pays the highest Medicaid rate for 81540?

Montana, at $3,750.00, effective 2022-01-01.

Do managed-care plans pay the same rate for 81540?

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.