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43286 Medicaid reimbursement rates by state

Physician and practitioner services (fee schedule). 48 state Medicaid programs publish a fee-for-service rate for 43286 at the physician psychologist level. Rates run from $363.92 in Oregon to $5,125.44 in Alaska, with a median of $2,483.81.

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

States publishing
48
Median rate
$2,483.81units vary by state
Highest
$5,125.44Alaska
Medicare (non-facility)
—not on the physician fee schedule

43286 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
AlaskaPhysician or licensed psychologist (incl. BCBA-D) · Alaska Medicaid (fee-for-service, Department of Health)$5,125.44since 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)$4,842.17since 2026-09-24——Not classified—Teaching Facility Fee Schedule
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$4,621.35since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$4,138.78since 2026-07-01——Not classified—Montana Healthcare Programs fee schedule
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$3,853.20since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$3,238.25since 2024-01-01——Plans must pay at least this—Provider Type 20 Physician, MD., Osteopa
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$3,029.55since 2026-10-01——Plans negotiate; applies out of network—AHCCCS Arizona Health Care Cost Containm
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$2,996.59since 2026-06-01——Plans must pay at least this—Medicaid Fee-For-Service (FFS) Fee Sched
New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service)$2,951.46since 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)$2,885.87since 2018-01-01——Plans must pay at least this—Louisiana Medicaid Professional Services
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$2,841.65since 2026-01-01——Plans negotiate; applies out of network—DMAP 2026 Physician Fee Schedule
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$2,801.83since 2026-01-01——Not classified—Maryland Medicaid Professional Services
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$2,797.90since 2018-01-01——Plans negotiate; applies out of network—Schedule of Maximum Allw Pymt Physician
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$2,791.07since 2018-01-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$2,771.47since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health)$2,654.98since 2026-07-01——Not classified—Wyoming Medicaid Downloadable Fee Schedu
South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services)$2,641.23since 2026-07-01——Not classified—South Dakota Medicaid Physician fee sche
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$2,621.11since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Local Health D
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$2,592.34since 2026-07-01——Plans must pay at least this—SoonerCare Title XIX Fee Schedule
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$2,552.49since 2026-01-01——Not classified—CMAP fee schedule: Physician Surgical 04
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$2,551.51since 2026-07-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical2.csv
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$2,547.68since 2018-01-01——Plans negotiate; applies out of network—Appendix DD to OAC 5160-1-60 (Non-Instit
UtahPhysician or licensed psychologist (incl. BCBA-D) · Utah Medicaid (fee-for-service, Traditional plan)$2,511.69since 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$2,511.50since 2020-01-01——Plans negotiate; applies out of network—KY Medicaid Physician fee schedule (2020
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$2,456.12since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$2,357.10since 2026-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$2,303.88since 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - CPT Code
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$2,302.13since 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)$2,290.66since 2026-01-01——Plans negotiate; applies out of network—Practitioner Fee Schedule (2026-01-01)
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$2,288.11since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$2,203.08since 2026-04-01——Plans negotiate; applies out of network—BMS RBRVS 2026 Effective 4/1/26 - 3/31/2
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$2,181.36since 2023-07-01——Plans negotiate; applies out of network—2026 Fee Schedule - Covered Procedures R
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$2,164.80since 2024-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$2,036.01since 2026-02-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$1,966.75since 2026-01-01——Not classified—MaineCare Fee Schedule (MaineCare UCR, H
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$1,879.48since 2018-01-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$1,878.23since 2026-01-01——Plans negotiate; applies out of network—MDHHS Practitioner and Medical Clinic Fe
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$1,692.95since 2026-07-01——Plans negotiate; applies out of network—HCA Physician-related services fee sched
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$1,479.03since 2024-07-01——Plans negotiate; applies out of network—SCDHHS Nurse Midwives Fee Schedule (sche
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$1,348.04since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$1,319.95since 2024-08-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$1,261.88since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$749.40since 2025-06-13——Not classified—Arkansas Medicaid Physician / CRNA / Fam
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$534.25since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$476.15since 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)$472.45since 2018-01-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
PennsylvaniaPhysician or licensed psychologist (incl. BCBA-D) · Pennsylvania Medical Assistance (fee-for-service)$413.77since 2018-07-02——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$363.92since 2026-02-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee

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 43286?

It depends on the state. Of the 48 states with a published fee-for-service rate, the median is $2,483.81. Alaska pays the most ($5,125.44) and Oregon the least ($363.92).

Which state pays the highest Medicaid rate for 43286?

Alaska, at $5,125.44, effective 2026-07-01.

Do managed-care plans pay the same rate for 43286?

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

Track 43286 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
Medicaid rates by state