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52315 Medicaid reimbursement rates by state

Physician and practitioner services (fee schedule). 44 state Medicaid programs publish a fee-for-service rate for 52315 at the physician psychologist level. Rates run from $9.30 in New Jersey to $659.73 in New Mexico, with a median of $288.17.

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

States publishing
44
Median rate
$288.17units vary by state
Highest
$659.73New Mexico
Medicare (non-facility)
$409.25–$583.352026 physician fee schedule

52315 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
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$659.73since 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)$643.17since 2026-07-01——Not classified—Montana Healthcare Programs fee schedule
AlabamaPhysician or licensed psychologist (incl. BCBA-D) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$628.66since 2026-09-24——Not classified—Teaching Facility Fee Schedule
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$444.25since 2026-01-01——Plans negotiate; applies out of network—DMAP 2026 Physician Fee Schedule
New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service)$429.40since 2023-10-01unit—Plans negotiate; applies out of network—eMedNY Physician Fee Schedule Sect 5 (Su
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$426.04since 2024-08-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$397.14since 2026-07-01——Plans must pay at least this—SoonerCare Title XIX Fee Schedule
UtahPhysician or licensed psychologist (incl. BCBA-D) · Utah Medicaid (fee-for-service, Traditional plan)$386.28since 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)$378.62since 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)$373.57since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$372.96since 2015-07-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$370.31since 2025-07-01——Plans must pay at least this—Louisiana Medicaid Professional Services
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$367.37since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$366.80since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$366.67since 2026-02-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$364.67since 2026-01-01——Not classified—CMAP fee schedule: Physician Surgical 04
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$346.06since 2026-02-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$333.54since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$313.54since 2026-04-01——Plans negotiate; applies out of network—BMS RBRVS 2026 Effective 4/1/26 - 3/31/2
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$311.44since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$309.77since 2026-01-01——Not classified—MaineCare Fee Schedule (MaineCare UCR, H
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$291.81since 2026-01-01——Plans negotiate; applies out of network—MDHHS Practitioner and Medical Clinic Fe
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$284.53since 2024-01-01——Plans must pay at least this—Provider Type 20 Physician, MD., Osteopa
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$271.76since 2020-01-01——Plans negotiate; applies out of network—KY Medicaid Physician fee schedule (2020
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$270.30since 2017-01-01——Plans negotiate; applies out of network—OutPatient Max Allowed Site of Service F
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$265.49since 2026-06-01——Plans must pay at least this—Medicaid Fee-For-Service (FFS) Fee Sched
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$252.91since 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)$252.11since 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)$246.98since 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)$246.38since 2024-07-01——Plans negotiate; applies out of network—SCDHHS Nurse Midwives Fee Schedule (sche
North CarolinaPhysician or licensed psychologist (incl. BCBA-D) · North Carolina Medicaid Direct (fee-for-service)$232.91since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Physician Serv
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$232.55since 2013-01-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$218.92since 2026-01-01——Not classified—Maryland Medicaid Professional Services
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$210.07since 2026-07-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical3.csv
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$203.77since 2026-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$198.77since 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)$188.59since 2026-01-01——Plans negotiate; applies out of network—Practitioner Fee Schedule (2026-01-01)
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$157.42since 2024-01-01——Plans negotiate; applies out of network—Appendix DD to OAC 5160-1-60 (Non-Instit
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$141.22since 2026-07-01——Plans negotiate; applies out of network—HCA Physician-related services fee sched
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$136.87since 2023-07-01——Plans negotiate; applies out of network—2026 Fee Schedule - Covered Procedures R
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$79.84since 2025-06-13——Not classified—Arkansas Medicaid Physician / CRNA / Fam
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$71.81since 2022-07-01——Plans must pay at least this—MO HealthNet fee schedule: Practitioner
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$18.90since 1993-04-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
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 52315?

It depends on the state. Of the 44 states with a published fee-for-service rate, the median is $288.17. New Mexico pays the most ($659.73) and New Jersey the least ($9.30 per base unit).

Which state pays the highest Medicaid rate for 52315?

New Mexico, at $659.73, effective 2025-01-01.

Do managed-care plans pay the same rate for 52315?

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 52315 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
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