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10080 Medicaid reimbursement rates by state

Physician and practitioner services (fee schedule). 22 state Medicaid programs publish a fee-for-service rate for 10080 at the physician psychologist level. Rates run from $9.30 in New Jersey to $236.22 in New York, with a median of $73.95.

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

States publishing
22
Median rate
$73.95units vary by state
Highest
$236.22New York
Medicare (non-facility)
$238.58–$369.442026 physician fee schedule

10080 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
New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service)$236.22since 2023-10-01unit—Plans negotiate; applies out of network—eMedNY Physician Fee Schedule Sect 5 (Su
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$185.43since 2025-03-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$185.43since 2026-01-01——Plans negotiate; applies out of network—Physician Pediatric Surgery Fee Schedule
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$171.89since 2026-01-01——Plans negotiate; applies out of network—MDHHS Certified Nurse Midwife Fee Schedu
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$143.14since 2026-01-01——Not classified—Maryland Medicaid Professional Services
ArizonaPhysician or licensed psychologist (incl. BCBA-D) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$115.79since 2024-10-01——Plans negotiate; applies out of network—AHCCCS Arizona Health Care Cost Containm
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$100.82since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$95.39since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$91.15since 2026-07-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical1.csv
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$79.47since 2026-10-01——Plans negotiate; applies out of network—Emergency Adoption (date filed: Septembe
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$78.73since 2026-02-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$69.17since 2024-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$68.87since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Nurse Practiti
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$65.57since 2022-07-01——Plans must pay at least this—MO HealthNet fee schedule: Practitioner
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$63.45since 2026-07-01——Plans negotiate; applies out of network—HCA Physician-related services fee sched
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$54.51since 2017-01-01——Plans negotiate; applies out of network—OutPatient Max Allowed Site of Service F
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$54.31since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$53.47since 2024-01-01——Plans negotiate; applies out of network—Appendix DD to OAC 5160-1-60 (Non-Instit
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$44.23since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$38.00since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal UA and UB Modifier Maximum Allo
PennsylvaniaPhysician or licensed psychologist (incl. BCBA-D) · Pennsylvania Medical Assistance (fee-for-service)$36.00since 2004-03-01——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$9.30since 2014-07-01base unit—Not classified—NJMMIS Procedure Master Listing CPTCodes

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 10080?

It depends on the state. Of the 22 states with a published fee-for-service rate, the median is $73.95. New York pays the most ($236.22 per unit) and New Jersey the least ($9.30 per base unit).

Which state pays the highest Medicaid rate for 10080?

New York, at $236.22 per unit, effective 2023-10-01.

Do managed-care plans pay the same rate for 10080?

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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