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42665 Medicaid reimbursement rates by state

Physician and practitioner services (fee schedule). 32 state Medicaid programs publish a fee-for-service rate for 42665 at the physician psychologist level. Rates run from $9.30 in New Jersey to $474.91 in Alabama, with a median of $166.95.

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

States publishing
32
Median rate
$166.95units vary by state
Highest
$474.91Alabama
Medicare (non-facility)
$324.16–$491.362026 physician fee schedule

42665 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)$474.91since 2026-09-24——Not classified—Teaching Facility Fee Schedule
New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service)$346.47since 2023-10-01unit—Plans negotiate; applies out of network—eMedNY Physician Fee Schedule Sect 5 (Su
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$315.22since 2026-07-01——Plans must pay at least this—SoonerCare Title XIX Fee Schedule
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$296.82since 2026-02-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$293.64since 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)$282.77since 2026-02-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$255.24since 2026-01-01——Not classified—Maryland Medicaid Professional Services
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$234.94since 2026-01-01——Plans negotiate; applies out of network—MDHHS Oral Maxillofacial Surgeon Fee Sch
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$224.94since 2024-08-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$203.95since 2026-10-01——Plans negotiate; applies out of network—AHCCCS Arizona Health Care Cost Containm
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$199.75since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$196.82since 2024-07-01——Plans negotiate; applies out of network—SCDHHS Nurse Midwives Fee Schedule (sche
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$179.37since 2013-07-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$176.20since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$171.01since 2026-07-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical2.csv
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$167.83since 2017-01-01——Plans negotiate; applies out of network—OutPatient Max Allowed Site of Service F
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$166.07since 2026-10-01——Plans negotiate; applies out of network—Emergency Adoption (date filed: Septembe
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$165.88since 2026-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$155.87since 2013-01-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$153.52since 2026-01-01——Plans negotiate; applies out of network—Practitioner Fee Schedule (2026-01-01)
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$151.80since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Nurse Practiti
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$141.62since 2025-05-15——Not classified—Arkansas Medicaid Oral Surgeon Fee Sched
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$136.34since 2024-01-01——Plans negotiate; applies out of network—Appendix DD to OAC 5160-1-60 (Non-Instit
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$132.10since 2020-01-01——Plans negotiate; applies out of network—KY Medicaid Physician fee schedule (2020
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$118.48since 2026-07-01——Plans negotiate; applies out of network—HCA Physician-related services fee sched
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$74.12since 2016-09-01——Not classified—CMAP fee schedule: 10/1/2026 Pediatric D
PennsylvaniaPhysician or licensed psychologist (incl. BCBA-D) · Pennsylvania Medical Assistance (fee-for-service)$74.00since 2004-03-01——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$65.63since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$57.56since 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)$48.83since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$23.66since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
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 42665?

It depends on the state. Of the 32 states with a published fee-for-service rate, the median is $166.95. Alabama pays the most ($474.91) and New Jersey the least ($9.30 per base unit).

Which state pays the highest Medicaid rate for 42665?

Alabama, at $474.91, effective 2026-09-24.

Do managed-care plans pay the same rate for 42665?

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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