20697 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 24 state Medicaid programs publish a fee-for-service rate for 20697 at the physician psychologist level. Rates run from $7.40 in Nebraska to $1,962.34 in Arizona, with a median of $1,070.08.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 24
- Median rate
- $1,070.08units vary by state
- Highest
- $1,962.34Arizona
- Medicare (non-facility)
- $1,646.99–$2,754.082026 physician fee schedule
20697 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 |
|---|---|---|---|---|---|---|
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $1,962.34since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $1,702.50since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $1,655.09since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file cptmedical1.csv |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $1,513.69since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $1,513.42since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $1,470.17since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Emergency Adoption (date filed: Septembe |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $1,425.63since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Practitioner Fee Schedule (2026-01-01) |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $1,356.84since 2026-03-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $1,323.73since 2025-07-01 | — | — | Plans must pay at least this | — | Louisiana Medicaid Professional Services |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $1,218.36since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Oral Maxillofacial Surgeon Fee Sch |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $1,206.61since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Physician-related services fee sched |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $1,115.87since 2024-04-01 | — | — | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $1,024.28since 2017-01-01 | — | — | Plans negotiate; applies out of network | — | OutPatient Max Allowed Site of Service F |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $981.78since 2020-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Physician fee schedule (2020 |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $977.63since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | Appendix DD to OAC 5160-1-60 (Non-Instit |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $960.38since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| North CarolinaPhysician or licensed psychologist (incl. BCBA-D) · North Carolina Medicaid Direct (fee-for-service) | $925.63since 2025-10-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Physician Serv |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $901.71since 2024-07-01 | — | — | Plans negotiate; applies out of network | — | SCDHHS Nurse Midwives Fee Schedule (sche |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $894.47since 2022-07-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Practitioner |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $219.80since 2019-06-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $212.96since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| PennsylvaniaPhysician or licensed psychologist (incl. BCBA-D) · Pennsylvania Medical Assistance (fee-for-service) | $117.92since 2016-09-08 | — | — | 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 2014-07-01 | base unit | — | Not classified | — | NJMMIS Procedure Master Listing CPTCodes |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $7.40since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
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 20697?
It depends on the state. Of the 24 states with a published fee-for-service rate, the median is $1,070.08. Arizona pays the most ($1,962.34) and Nebraska the least ($7.40).
Which state pays the highest Medicaid rate for 20697?
Arizona, at $1,962.34, effective 2026-10-01.
Do managed-care plans pay the same rate for 20697?
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.
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Track 20697 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.