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28160 Medicaid reimbursement rates by state

Physician and practitioner services (fee schedule). 41 state Medicaid programs publish a fee-for-service rate for 28160 at the physician psychologist level. Rates run from $9.30 in New Jersey to $647.46 in Alabama, with a median of $253.77.

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

States publishing
41
Median rate
$253.77units vary by state
Highest
$647.46Alabama
Medicare (non-facility)
$362.78–$532.922026 physician fee schedule

28160 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
AlabamaPhysician or licensed psychologist (incl. BCBA-D) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$647.46since 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)$571.80since 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)$569.10since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service)$369.46since 2023-10-01unit—Plans negotiate; applies out of network—eMedNY Physician Fee Schedule Sect 5 (Su
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$369.08since 2026-01-01——Not classified—Maryland Medicaid Professional Services
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$351.39since 2026-07-01——Plans must pay at least this—SoonerCare Title XIX Fee Schedule
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$342.40since 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$339.53since 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - CPT Code
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$329.87since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$327.95since 2026-02-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$327.07since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$319.73since 2025-07-01——Plans must pay at least this—Louisiana Medicaid Professional Services
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$312.10since 2026-02-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$309.50since 2013-07-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$286.07since 2024-08-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$284.21since 2024-01-01——Plans must pay at least this—Provider Type 20 Physician, MD., Osteopa
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$275.48since 2026-01-01——Not classified—MaineCare Fee Schedule (MaineCare UCR, H
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$273.77since 2026-04-01——Plans negotiate; applies out of network—BMS RBRVS 2026 Effective 4/1/26 - 3/31/2
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$265.21since 2026-10-01——Plans negotiate; applies out of network—AHCCCS Arizona Health Care Cost Containm
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$259.43since 2026-01-01——Plans negotiate; applies out of network—MDHHS Podiatrist Fee Schedule, January 2
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$253.77since 2026-01-01——Not classified—CMAP fee schedule: Physician Surgical 04
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$251.78since 2017-01-01——Plans negotiate; applies out of network—OutPatient Max Allowed Site of Service F
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$250.75since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$248.37since 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)$247.66since 2022-07-01——Plans must pay at least this—MO HealthNet fee schedule: Practitioner
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$245.48since 2025-06-13——Not classified—Arkansas Medicaid Physician / CRNA / Fam
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$229.59since 2026-03-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$225.08since 2020-01-01——Plans negotiate; applies out of network—KY Medicaid Physician fee schedule (2020
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$221.35since 2026-07-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical1.csv
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$218.63since 2019-09-11——Plans negotiate; applies out of network—HFS Podiatrist Fee Schedule (effective 2
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$214.17since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$208.23since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Nurse Practiti
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$201.03since 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)$198.72since 2026-01-01——Plans negotiate; applies out of network—Practitioner Fee Schedule (2026-01-01)
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$175.35since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$163.93since 2024-07-01——Plans negotiate; applies out of network—SCDHHS Nurse Midwives Fee Schedule (sche
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$161.65since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$153.26since 2026-07-01——Plans negotiate; applies out of network—HCA Physician-related services fee sched
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$136.00since 2024-01-01——Plans negotiate; applies out of network—Appendix DD to OAC 5160-1-60 (Non-Instit
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$82.12since 2023-07-01——Plans negotiate; applies out of network—2026 Fee Schedule - Covered Procedures R
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 28160?

It depends on the state. Of the 41 states with a published fee-for-service rate, the median is $253.77. Alabama pays the most ($647.46) and New Jersey the least ($9.30 per base unit).

Which state pays the highest Medicaid rate for 28160?

Alabama, at $647.46, effective 2026-09-24.

Do managed-care plans pay the same rate for 28160?

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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