53865 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 18 state Medicaid programs publish a fee-for-service rate for 53865 at the physician psychologist level. Rates run from $68.14 in New Jersey to $2,596.58 in New Mexico, with a median of $1,768.19.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 18
- Median rate
- $1,768.19units vary by state
- Highest
- $2,596.58New Mexico
- Medicare (non-facility)
- $2,676.01–$3,665.982026 physician fee schedule
53865 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 |
|---|---|---|---|---|---|---|
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $2,596.58since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service CPT |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $2,436.88since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $2,436.61since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $2,343.62since 2026-07-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $2,297.43since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Physician fee schedule (2025 |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $2,268.36since 2025-01-01 | — | — | Plans must pay at least this | — | Louisiana Medicaid Professional Services |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $2,174.70since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $1,968.33since 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) | $1,859.62since 2026-01-01 | — | — | Not classified | — | CMAP fee schedule: Physician Surgical 04 |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $1,676.76since 2025-01-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $1,627.67since 2025-01-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Practitioner |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $151.19since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $135.43since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | Max Allow Payment_OutP Site of Service ( |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $126.16since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file cptmedical3.csv |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $122.76since 2025-01-01 | — | — | 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) | $121.40since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | Administrative Bulletin 25-03: 101 CMR 3 |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $108.69since 2025-01-01 | — | — | 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) | $68.14since 2026-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
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 53865?
It depends on the state. Of the 18 states with a published fee-for-service rate, the median is $1,768.19. New Mexico pays the most ($2,596.58) and New Jersey the least ($68.14).
Which state pays the highest Medicaid rate for 53865?
New Mexico, at $2,596.58, effective 2025-01-01.
Do managed-care plans pay the same rate for 53865?
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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