55868 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 36 state Medicaid programs publish a fee-for-service rate for 55868 at the physician psychologist level. Rates run from $171.11 in Rhode Island to $8,752.69 in New Hampshire, with a median of $872.27.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 36
- Median rate
- $872.27units vary by state
- Highest
- $8,752.69New Hampshire
- Medicare (non-facility)
- —not on the physician fee schedule
55868 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 HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $8,752.69⚠ over 3× mediansince 2026-01-01 | — | — | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| AlabamaPhysician or licensed psychologist (incl. BCBA-D) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $1,677.48since 2026-09-24 | — | — | Not classified | — | Teaching Facility Fee Schedule |
| MontanaPhysician or licensed psychologist (incl. BCBA-D) · Montana Medicaid and HMK Plus (fee-for-service) | $1,556.58since 2026-07-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $1,167.83since 2026-01-01 | — | — | 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) | $1,150.78since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service | $1,102.30since 2026-06-01 | — | — | Plans must pay at least this | — | Medicaid Fee-For-Service (FFS) Fee Sched |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $1,006.53since 2026-07-01 | — | — | Not classified | — | South Dakota Medicaid Physician fee sche |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $1,004.48since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $973.67since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file cptmedical3.csv |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $959.47since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Schedule of Maximum Allw Pymt Physician |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $950.86since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Physician fee schedule (2026 |
| New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service) | $949.17since 2026-01-01 | unit | — | Plans negotiate; applies out of network | — | eMedNY Physician Fee Schedule Sect 5 (Su |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $941.44since 2026-01-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, June 202 |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $923.48since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $901.54since 2026-01-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Nurse Practiti |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $897.33since 2026-01-01 | — | — | Not classified | — | Vermont Medicaid Fee Schedule - CPT Code |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $894.71since 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) | $872.78since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $871.76since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $868.57since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | ODM CPT/HCPCS procedure code changes for |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $861.40since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Practitioner Fee Schedule (2026-01-01) |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $849.40since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $812.80since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Administrative Bulletin 26-09: 101 CMR 3 |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $806.12since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $803.74since 2026-04-01 | — | — | Plans negotiate; applies out of network | — | BMS RBRVS 2026 Effective 4/1/26 - 3/31/2 |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $776.22since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $760.21since 2026-01-01 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $744.85since 2026-01-01 | — | — | 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) | $706.31since 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) | $668.74since 2026-01-01 | — | — | Not classified | — | CMAP fee schedule: Physician Surgical 04 |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $647.06since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Physician-related services fee sched |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $513.41since 2026-01-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Practitioner |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $258.60since 2026-01-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $246.92since 2026-03-25 | — | — | Not classified | — | Arkansas Medicaid Physician / CRNA / Fam |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $182.51since 2026-01-01 | — | — | Plans must pay at least this | — | Louisiana Medicaid Professional Services |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service) | $171.11since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | RI Medicaid Interactive Fee For Service |
Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 55868?
It depends on the state. Of the 36 states with a published fee-for-service rate, the median is $872.27. New Hampshire pays the most ($8,752.69) and Rhode Island the least ($171.11).
Which state pays the highest Medicaid rate for 55868?
New Hampshire, at $8,752.69, effective 2026-01-01.
Do managed-care plans pay the same rate for 55868?
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
10005Physician and practitioner services (fee schedule) · 48 states10006Physician and practitioner services (fee schedule) · 48 states10007Physician and practitioner services (fee schedule) · 48 states10008Physician and practitioner services (fee schedule) · 48 states10009Physician and practitioner services (fee schedule) · 48 states10010Physician and practitioner services (fee schedule) · 48 states10021Physician and practitioner services (fee schedule) · 48 states10030Physician and practitioner services (fee schedule) · 48 states10060Physician and practitioner services (fee schedule) · 48 states10061Physician and practitioner services (fee schedule) · 48 states10080Physician and practitioner services (fee schedule) · 48 states10081Physician and practitioner services (fee schedule) · 48 states
Track 55868 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.