43496 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 33 state Medicaid programs publish a fee-for-service rate for 43496 at the physician psychologist level. Rates run from $0.00 in Arkansas to $5,882.80 in Nevada, with a median of $1,054.64.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 33
- Median rate
- $1,054.64units vary by state
- Highest
- $5,882.80Nevada
- Medicare (non-facility)
- —not on the physician fee schedule
43496 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 |
|---|---|---|---|---|---|---|
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $5,882.80⚠ over 3× mediansince 2024-01-01 | — | — | Plans must pay at least this | — | Provider Type 20 Physician, MD., Osteopa |
| AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $3,051.00since 2026-08-25 | — | — | Not classified | — | Physician Fee Schedule (REF-0129-Q) |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $2,635.69since 2013-02-01 | — | — | Plans must pay at least this | — | Louisiana Medicaid Professional Services |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $2,436.61since 2009-12-18 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service | $2,435.60since 2026-06-01 | — | — | Plans must pay at least this | — | Medicaid Fee-For-Service (FFS) Fee Sched |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $1,762.77since 2024-01-01 | — | — | Plans must pay at least this | — | SoonerCare Title XIX Fee Schedule |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $1,747.63since 2022-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, May 2023 |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $1,730.58since 2013-01-01 | — | — | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $1,694.04since 2013-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $1,693.68since 2026-04-01 | — | — | Plans negotiate; applies out of network | — | BMS Palmetto Priced Codes Fee Schedule |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $1,588.64since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $1,483.40since 2022-07-01 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $1,350.05since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $1,320.61since 2013-09-01 | — | — | 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) | $1,302.74since 2023-07-01 | — | — | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $1,249.87since 2023-10-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Practitioner and Medical Clinic Fe |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $1,054.64since 2025-07-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $1,014.88since 2024-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $949.24since 2020-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $921.50since 2022-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Physician-related services fee sched |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $889.92since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service CPT |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $752.58since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $739.80since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $727.46since 2022-07-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Practitioner |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $706.89since 2009-07-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file cptmedical2.csv |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $696.36since 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) | $676.31since 2023-01-01 | unit | — | Plans negotiate; applies out of network | — | eMedNY Physician Fee Schedule Sect 5 (Su |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $655.85since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $466.28since 2008-07-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $245.47since 2026-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $40.00since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal UA and UB Modifier Maximum Allo |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $9.30since 2014-07-01 | base unit | — | Not classified | — | NJMMIS Procedure Master Listing CPTCodes |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $0.00since 2025-06-13 | — | — | Not classified | — | Arkansas Medicaid Physician / CRNA / Fam |
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 43496?
It depends on the state. Of the 33 states with a published fee-for-service rate, the median is $1,054.64. Nevada pays the most ($5,882.80) and Arkansas the least ($0.00).
Which state pays the highest Medicaid rate for 43496?
Nevada, at $5,882.80, effective 2024-01-01.
Do managed-care plans pay the same rate for 43496?
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 43496 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.