21497 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 41 state Medicaid programs publish a fee-for-service rate for 21497 at the physician psychologist level. Rates run from $51.60 in Rhode Island to $1,143.05 in Alaska, with a median of $486.69.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 41
- Median rate
- $486.69units vary by state
- Highest
- $1,143.05Alaska
- Medicare (non-facility)
- $636.39–$968.832026 physician fee schedule
21497 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 |
|---|---|---|---|---|---|---|
| AlaskaPhysician or licensed psychologist (incl. BCBA-D) · Alaska Medicaid (fee-for-service, Department of Health) | $1,143.05since 2026-07-01 | — | — | Not classified | — | Alaska Medicaid Physician Fee Schedule S |
| AlabamaPhysician or licensed psychologist (incl. BCBA-D) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $1,112.59since 2026-09-24 | — | — | Not classified | — | Teaching Facility Fee Schedule |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $1,007.97since 2026-07-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $973.48since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service CPT |
| DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP) | $695.72since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | DMAP 2026 Physician Fee Schedule |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $681.32since 2026-07-01 | — | — | Not classified | — | South Dakota Medicaid Physician fee sche |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $656.51since 2024-01-01 | — | — | Plans must pay at least this | — | Provider Type 20 Physician, MD., Osteopa |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service | $627.28since 2026-06-01 | — | — | Plans must pay at least this | — | Medicaid Fee-For-Service (FFS) Fee Sched |
| WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health) | $616.00since 2026-07-01 | — | — | Not classified | — | Wyoming Medicaid Downloadable Fee Schedu |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $612.91since 2026-07-01 | — | — | Plans must pay at least this | — | SoonerCare Title XIX Fee Schedule |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $601.01since 2026-01-01 | — | — | Not classified | — | Vermont Medicaid Fee Schedule - CPT Code |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $600.47since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| UtahPhysician or licensed psychologist (incl. BCBA-D) · Utah Medicaid (fee-for-service, Traditional plan) | $600.00since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $580.16since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $579.99since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $574.00since 2026-07-01 | — | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $573.00since 2026-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, Septembe |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $555.51since 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) | $533.54since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $497.35since 2024-03-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $486.69since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file cptmedical1.csv |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $485.25since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $482.80since 2026-01-01 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $477.12since 2017-01-01 | — | — | Plans negotiate; applies out of network | — | Appendix DD to OAC 5160-1-60 (Non-Instit |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $474.58since 2026-04-01 | — | — | Plans negotiate; applies out of network | — | BMS RBRVS 2026 Effective 4/1/26 - 3/31/2 |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $460.96since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Emergency Adoption (date filed: Septembe |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $445.43since 2026-01-01 | — | — | Not classified | — | CMAP fee schedule: Physician Surgical 04 |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $436.93since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Practitioner Fee Schedule (2026-01-01) |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $415.23since 2024-08-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $395.11since 2025-10-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Nurse Practiti |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $372.50since 2024-04-01 | — | — | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $344.74since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Physician-related services fee sched |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $280.60since 2013-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $263.75since 2008-07-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $253.21since 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) | $221.65since 2020-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Physician fee schedule (2020 |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $192.34since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $164.22since 2023-07-01 | — | — | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $108.82since 2022-07-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Practitioner |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $67.14since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service) | $51.60since 1993-04-01 | — | — | Plans negotiate; applies out of network | — | RI Medicaid Interactive Fee For Service |
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 21497?
It depends on the state. Of the 41 states with a published fee-for-service rate, the median is $486.69. Alaska pays the most ($1,143.05) and Rhode Island the least ($51.60).
Which state pays the highest Medicaid rate for 21497?
Alaska, at $1,143.05, effective 2026-07-01.
Do managed-care plans pay the same rate for 21497?
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 21497 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.