53860 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 28 state Medicaid programs publish a fee-for-service rate for 53860 at the physician psychologist level. Rates run from $41.13 in Kansas to $3,361.57 in Montana, with a median of $1,167.56.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 28
- Median rate
- $1,167.56units vary by state
- Highest
- $3,361.57Montana
- Medicare (non-facility)
- $2,067.01–$3,391.112026 physician fee schedule
53860 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 |
|---|---|---|---|---|---|---|
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $3,361.57since 2026-07-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $3,185.69since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service CPT |
| AlabamaPhysician or licensed psychologist (incl. BCBA-D) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $2,290.06since 2026-09-24 | — | — | Not classified | — | Teaching Facility Fee Schedule |
| New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service) | $2,268.09since 2023-10-01 | unit | — | 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) | $2,010.79since 2026-07-01 | — | — | Plans must pay at least this | — | SoonerCare Title XIX Fee Schedule |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $1,903.70since 2026-07-01 | — | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $1,869.14since 2026-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, Septembe |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $1,596.96since 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) | $1,525.08since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Practitioner and Medical Clinic Fe |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $1,434.16since 2026-01-01 | — | — | Not classified | — | CMAP fee schedule: Physician Surgical 04 |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $1,306.04since 2013-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $1,274.92since 2020-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Physician fee schedule (2020 |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $1,263.01since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $1,243.99since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $1,091.13since 2024-07-01 | — | — | Plans negotiate; applies out of network | — | SCDHHS Nurse Midwives Fee Schedule (sche |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $474.24since 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) | $376.22since 2022-07-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Practitioner |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $351.76since 2025-06-13 | — | — | Not classified | — | Arkansas Medicaid Physician / CRNA / Fam |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $245.74since 2024-01-01 | — | — | Plans must pay at least this | — | Provider Type 20 Physician, MD., Osteopa |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $203.96since 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) | $196.78since 2017-01-01 | — | — | Plans negotiate; applies out of network | — | OutPatient Max Allowed Site of Service F |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $194.34since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $186.77since 2013-12-31 | — | — | Plans negotiate; applies out of network | — | Appendix DD to OAC 5160-1-60 (Non-Instit |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $163.38since 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) | $148.28since 2024-04-01 | — | — | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $147.23since 2011-01-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $101.49since 2026-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $41.13since 2011-01-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
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 53860?
It depends on the state. Of the 28 states with a published fee-for-service rate, the median is $1,167.56. Montana pays the most ($3,361.57) and Kansas the least ($41.13).
Which state pays the highest Medicaid rate for 53860?
Montana, at $3,361.57, effective 2026-07-01.
Do managed-care plans pay the same rate for 53860?
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 53860 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.