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54240 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $52.97 for 54240 across 36 states, from $9.30 in New Jersey to $152.52 in Alabama.

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

States publishing
36
National median
$52.97units vary by state
Lowest
$9.30New Jersey
Highest
$152.52Alabama

What does Medicaid pay for 54240?

36 state Medicaid programs publish a fee-for-service rate for 54240 at the physician psychologist level. The national median is $52.97 (units differ between states). Alabama pays the most, $152.52, and New Jersey the least, $9.30 per base unit, a 16.4x spread.

Medicare (non-facility, 2026 physician fee schedule): $100.99–$143.03 depending on the state's Medicare locality.

54240 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 36 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Alabama Source · since 2026-09-24$152.52——Not classified—
2Arizona Source · since 2026-10-01$116.85——Plans negotiate; applies out of network—
3Hawaii Source · since 2026-06-01$111.99——Plans must pay at least this—
18Kentucky Source · since 2020-01-01$53.58——Plans negotiate; applies out of network—
19Oregon Source · since 2026-02-01$52.36——Plans negotiate; applies out of network—
20Colorado Source · since 2026-07-01$52.25——Plans negotiate; applies out of network—
35Rhode Island Source · since 1996-01-01$11.23——Plans negotiate; applies out of network—
36New Jersey Source · since 2014-07-01$9.30base unit—Not classified—
See all 36 states for 54240 — start free

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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; states with several Medicare localities show a range. Confirm rates with the payer before billing.

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Frequently asked questions

What does Medicaid pay for 54240?

It depends on the state. Of the 36 states with a published fee-for-service rate, the median is $52.97. Alabama pays the most ($152.52) and New Jersey the least ($9.30 per base unit).

Which state pays the highest Medicaid rate for 54240?

Alabama, at $152.52, effective 2026-09-24.

Do managed-care plans pay the same rate for 54240?

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 workspace shows the rule for each state, cited to the contract or statute.

Related codes

Codes next to 54240

54220Physician and practitioner services (fee schedule) · 49 states54230Physician and practitioner services (fee schedule) · 43 states54231Physician and practitioner services (fee schedule) · 41 states54235Physician and practitioner services (fee schedule) · 41 states54250Physician and practitioner services (fee schedule) · 33 states54300Physician and practitioner services (fee schedule) · 49 states54304Physician and practitioner services (fee schedule) · 49 states54308Physician and practitioner services (fee schedule) · 49 states

Most-published Physician & professional codes

10005Physician and practitioner services (fee schedule) · 50 states10006Physician and practitioner services (fee schedule) · 50 states10007Physician and practitioner services (fee schedule) · 50 states10008Physician and practitioner services (fee schedule) · 50 states10009Physician and practitioner services (fee schedule) · 50 states10010Physician and practitioner services (fee schedule) · 50 states10021Physician and practitioner services (fee schedule) · 50 states10030Physician and practitioner services (fee schedule) · 50 states

Highest-paying states

Alabama Medicaid fee scheduleArizona Medicaid fee scheduleHawaii Medicaid fee schedule