86910 Medicaid reimbursement rates by state
Clinical lab tests. 11 state Medicaid programs publish a fee-for-service rate for 86910 at the physician psychologist level. Rates run from $12.60 in New Jersey to $35.63 in Indiana, with a median of $25.45.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 11
- Median rate
- $25.45units vary by state
- Highest
- $35.63Indiana
- Medicare (non-facility)
- —not on the physician fee schedule
86910 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 |
|---|---|---|---|---|---|---|
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $35.63since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $29.40since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service CPT |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Chronic Disease Program (adult cystic fibrosis, hemophilia home care, chronic renal disease; state-funded) | $26.79since 2006-10-01 | — | — | Not classified | — | ForwardHealth max fee schedule: Renal Di |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $25.68since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $25.45since 2021-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Clinical Lab fee schedule (2 |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $25.45since 2025-03-26 | — | — | Not classified | — | Arkansas Medicaid Independent Laboratory |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $23.45since 2018-10-01 | — | — | Plans negotiate; applies out of network | — | Lab Max Allowable (in Zipped 2018 Fee Sc |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $23.40since 2013-01-01 | — | — | 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) | $16.00since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Practitioner Laboratory Fee Schedule (20 |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $15.66since 2012-07-01 | — | — | Plans must pay at least this | — | Louisiana Medicaid Laboratory and Radiol |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $12.60since 2025-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
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 86910?
It depends on the state. Of the 11 states with a published fee-for-service rate, the median is $25.45. Indiana pays the most ($35.63 per unit) and New Jersey the least ($12.60).
Which state pays the highest Medicaid rate for 86910?
Indiana, at $35.63 per unit, effective 2026-01-01.
Do managed-care plans pay the same rate for 86910?
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.