43290 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 16 state Medicaid programs publish a fee-for-service rate for 43290 at the physician psychologist level. Rates run from $79.13 in New Jersey to $2,365.21 in Maryland, with a median of $161.23.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 16
- Median rate
- $161.23units vary by state
- Highest
- $2,365.21Maryland
- Medicare (non-facility)
- $2,315.76–$3,168.502026 physician fee schedule
43290 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 |
|---|---|---|---|---|---|---|
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $2,365.21⚠ over 3× mediansince 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $2,104.79⚠ over 3× mediansince 2023-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Physician fee schedule (2023 |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $1,990.38⚠ over 3× mediansince 2026-01-01 | — | — | Not classified | — | CMAP fee schedule: Physician Surgical 04 |
| New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service) | $1,801.26since 2023-04-01 | unit | — | Plans negotiate; applies out of network | — | eMedNY Physician Fee Schedule Sect 5 (Su |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $1,701.87⚠ over 3× mediansince 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Practitioner and Medical Clinic Fe |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $396.47since 2023-01-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Practitioner |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $237.12since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $163.59since 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) | $158.86since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $149.93since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | Max Allow Payment_OutP Site of Service J |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $148.16since 2026-07-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $138.96since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | Appendix DD to OAC 5160-1-60 (Non-Instit |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $136.28since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file cptmedical2.csv |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $131.59since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Emergency Adoption (date filed: Septembe |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $122.74since 2024-04-01 | — | — | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $79.13since 2026-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of 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 43290?
It depends on the state. Of the 16 states with a published fee-for-service rate, the median is $161.23. Maryland pays the most ($2,365.21) and New Jersey the least ($79.13).
Which state pays the highest Medicaid rate for 43290?
Maryland, at $2,365.21, effective 2026-01-01.
Do managed-care plans pay the same rate for 43290?
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.