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69530 Medicaid reimbursement rates by state

Physician and practitioner services (fee schedule). 28 state Medicaid programs publish a fee-for-service rate for 69530 at the physician psychologist level. Rates run from $9.30 in New Jersey to $2,535.80 in Alabama, with a median of $1,145.57.

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

States publishing
28
Median rate
$1,145.57units vary by state
Highest
$2,535.80Alabama
Medicare (non-facility)
—not on the physician fee schedule

69530 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
AlabamaPhysician or licensed psychologist (incl. BCBA-D) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$2,535.80since 2026-09-24——Not classified—Teaching Facility Fee Schedule
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$1,573.55since 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)$1,539.11since 2023-10-01unit—Plans negotiate; applies out of network—eMedNY Physician Fee Schedule Sect 5 (Su
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$1,514.56since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$1,477.39since 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)$1,367.30since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$1,332.67since 2025-07-01——Plans must pay at least this—Louisiana Medicaid Professional Services
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$1,318.87since 2026-07-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical3.csv
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$1,288.51since 2026-10-01——Plans negotiate; applies out of network—Emergency Adoption (date filed: Septembe
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$1,223.92since 2013-07-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$1,213.78since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Nurse Practiti
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$1,184.04since 2026-01-01——Plans negotiate; applies out of network—Practitioner Fee Schedule (2026-01-01)
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$1,166.34since 2013-01-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$1,156.70since 2017-01-01——Plans negotiate; applies out of network—Physician Maximum Allowed Fee Schedule -
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$1,134.43since 2026-02-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$1,049.35since 2026-01-01——Not classified—CMAP fee schedule: Physician Surgical 04
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$1,019.34since 2020-01-01——Plans negotiate; applies out of network—KY Medicaid Physician fee schedule (2020
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$1,004.87since 2024-01-01——Plans negotiate; applies out of network—Appendix DD to OAC 5160-1-60 (Non-Instit
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$970.85since 2026-01-01——Plans negotiate; applies out of network—MDHHS Practitioner and Medical Clinic Fe
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$912.31since 2026-07-01——Plans negotiate; applies out of network—HCA Physician-related services fee sched
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$750.16since 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)$457.18since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$338.00since 2010-09-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$307.46since 2022-07-01——Plans must pay at least this—MO HealthNet fee schedule: Practitioner
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$281.70since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$208.72since 2026-03-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Certi
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$193.83since 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 69530?

It depends on the state. Of the 28 states with a published fee-for-service rate, the median is $1,145.57. Alabama pays the most ($2,535.80) and New Jersey the least ($9.30 per base unit).

Which state pays the highest Medicaid rate for 69530?

Alabama, at $2,535.80, effective 2026-09-24.

Do managed-care plans pay the same rate for 69530?

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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