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0225U Medicaid reimbursement rates by state

Physician and practitioner services (fee schedule). 13 state Medicaid programs publish a fee-for-service rate for 0225U at the physician psychologist level. Rates run from $60.33 in Colorado to $416.78 in Iowa, with a median of $375.10.

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

States publishing
13
Median rate
$375.10units vary by state
Highest
$416.78Iowa
Medicare (non-facility)
—not on the physician fee schedule

0225U 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
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$416.78since 2021-10-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$416.78since 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)$416.78since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$416.78since 2021-01-01——Plans negotiate; applies out of network—Nebraska Medicaid ad hoc fee schedule: C
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$416.78since 2026-02-01——Not classified—Maryland Medicaid Medical Laboratory Fee
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$416.78since 2022-01-01——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)$375.10since 2026-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Independent L
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$333.42since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$312.59since 2025-04-01——Plans negotiate; applies out of network—ODM laboratory services payment schedule
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$298.60since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Laboratory' -
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$262.77since 2020-08-10——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical1.csv
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$225.06since 2026-01-01——Plans negotiate; applies out of network—Independent Laboratory Fee Schedule (202
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$60.33since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee

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 0225U?

It depends on the state. Of the 13 states with a published fee-for-service rate, the median is $375.10. Iowa pays the most ($416.78) and Colorado the least ($60.33).

Which state pays the highest Medicaid rate for 0225U?

Iowa, at $416.78, effective 2021-10-01.

Do managed-care plans pay the same rate for 0225U?

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 Physician & professional codes

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