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54410 Medicaid reimbursement rates by state

Physician and practitioner services (fee schedule). 22 state Medicaid programs publish a fee-for-service rate for 54410 at the physician psychologist level. Rates run from $9.30 in New Jersey to $1,243.65 in New Mexico, with a median of $681.23.

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

States publishing
22
Median rate
$681.23units vary by state
Highest
$1,243.65New Mexico
Medicare (non-facility)
—not on the physician fee schedule

54410 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)$1,243.65since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$892.06since 2024-01-01——Plans must pay at least this—Provider Type 20 Physician, MD., Osteopa
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$812.27since 2026-10-01——Plans negotiate; applies out of network—AHCCCS Arizona Health Care Cost Containm
New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service)$767.08since 2023-10-01unit—Plans negotiate; applies out of network—eMedNY Physician Fee Schedule Sect 5 (Su
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$739.53since 2017-01-01——Plans negotiate; applies out of network—Physician Maximum Allowed Fee Schedule -
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$733.77since 2013-02-01——Plans must pay at least this—Louisiana Medicaid Professional Services
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$706.00since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$696.65since 2026-07-01——Plans must pay at least this—SoonerCare Title XIX Fee Schedule
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$694.09since 2026-01-01——Not classified—CMAP fee schedule: Physician Surgical 04
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$693.56since 2023-01-01——Plans must pay at least this—NC Medicaid fee schedule 'Nurse Practiti
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$684.79since 2026-01-01——Not classified—Maryland Medicaid Professional Services
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$677.66since 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)$656.51since 2024-01-01——Plans negotiate; applies out of network—Appendix DD to OAC 5160-1-60 (Non-Instit
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$656.06since 2020-01-01——Plans negotiate; applies out of network—KY Medicaid Physician fee schedule (2020
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$635.06since 2026-10-01——Plans negotiate; applies out of network—Emergency Adoption (date filed: Septembe
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$572.74since 2026-02-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$498.85since 2026-01-01——Plans negotiate; applies out of network—MDHHS Practitioner and Medical Clinic Fe
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$408.51since 2024-07-01——Plans negotiate; applies out of network—SCDHHS Nurse Midwives Fee Schedule (sche
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$211.72since 2009-12-18——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$182.17since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$98.85since 2026-02-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
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 54410?

It depends on the state. Of the 22 states with a published fee-for-service rate, the median is $681.23. New Mexico pays the most ($1,243.65) and New Jersey the least ($9.30 per base unit).

Which state pays the highest Medicaid rate for 54410?

New Mexico, at $1,243.65, effective 2025-01-01.

Do managed-care plans pay the same rate for 54410?

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

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