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11642 Medicaid reimbursement rates by state

Physician and practitioner services (fee schedule). 25 state Medicaid programs publish a fee-for-service rate for 11642 at the physician psychologist level. Rates run from $9.30 in New Jersey to $244.12 in Nebraska, with a median of $160.52.

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

States publishing
25
Median rate
$160.52units vary by state
Highest
$244.12Nebraska
Medicare (non-facility)
$242.92–$347.482026 physician fee schedule

11642 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
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$244.12since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service)$242.65since 2023-10-01unit—Plans negotiate; applies out of network—eMedNY Physician Fee Schedule Sect 5 (Su
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$242.48since 2026-01-01——Plans must pay at least this—Louisiana Medicaid Enhanced Professional
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$224.04since 2009-10-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$216.57since 2026-01-01——Not classified—Maryland Medicaid Professional Services
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$215.89since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$207.56since 2026-01-01——Plans negotiate; applies out of network—Practitioner Fee Schedule (2026-01-01)
ArizonaPhysician or licensed psychologist (incl. BCBA-D) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$198.82since 2024-10-01——Plans negotiate; applies out of network—AHCCCS Arizona Health Care Cost Containm
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$186.15since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$170.78since 2024-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$170.19since 2026-01-01——Plans negotiate; applies out of network—MDHHS Oral Maxillofacial Surgeon Fee Sch
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$165.38since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$160.52since 2022-07-01——Plans must pay at least this—MO HealthNet fee schedule: Practitioner
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$159.03since 2020-01-01——Plans negotiate; applies out of network—KY Medicaid Physician fee schedule (2020
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$152.97since 2025-03-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$147.92since 2017-01-01——Plans negotiate; applies out of network—OutPatient Max Allowed Site of Service F
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$140.85since 2024-07-01——Plans negotiate; applies out of network—SCDHHS Nurse Midwives Fee Schedule (sche
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$136.24since 2026-10-01——Plans negotiate; applies out of network—Emergency Adoption (date filed: Septembe
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$135.00since 2004-03-01——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$133.97since 2026-07-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical1.csv
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$133.13since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Nurse Practiti
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$115.61since 2024-01-01——Plans negotiate; applies out of network—Appendix DD to OAC 5160-1-60 (Non-Instit
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$115.01since 2026-02-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$91.92since 2026-07-01——Plans negotiate; applies out of network—HCA Physician-related services fee sched
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 11642?

It depends on the state. Of the 25 states with a published fee-for-service rate, the median is $160.52. Nebraska pays the most ($244.12) and New Jersey the least ($9.30 per base unit).

Which state pays the highest Medicaid rate for 11642?

Nebraska, at $244.12, effective 2026-07-01.

Do managed-care plans pay the same rate for 11642?

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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