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78431 Medicaid reimbursement rates by state

Imaging and radiology. 34 state Medicaid programs publish a fee-for-service rate for 78431 at the physician psychologist level. Rates run from $5.70 in Kansas to $3,907.20 in Nebraska, with a median of $313.40.

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

States publishing
34
Median rate
$313.40units vary by state
Highest
$3,907.20Nebraska
Medicare (non-facility)
—not on the physician fee schedule

78431 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
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$3,907.20⚠ over 3× mediansince 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$2,049.47since 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)$1,960.67⚠ over 3× mediansince 2026-01-01——Not classified—Maryland Medicaid Professional Services
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$1,881.68⚠ over 3× mediansince 2026-07-01——Plans must pay at least this—SoonerCare Title XIX Fee Schedule
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$1,830.23⚠ over 3× mediansince 2026-07-01——Plans negotiate; applies out of network—HCA Physician-related services fee sched
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$1,775.83⚠ over 3× mediansince 2024-07-01——Plans must pay at least this—Iowa Medicaid fee schedule #68 PHYSICIAN
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$1,743.92⚠ over 3× mediansince 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$1,537.59⚠ over 3× mediansince 2020-01-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$1,420.77since 2024-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$1,339.89since 2025-09-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$1,324.13since 2026-01-01——Not classified—CMAP fee schedule: Physician Radiology 7
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$1,314.34since 2025-01-01——Plans negotiate; applies out of network—2026 Fee Schedule - Covered Procedures R
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$1,219.66since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$1,030.33since 2022-07-01——Not classified—MaineCare Fee Schedule (MaineCare UCR, H
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$788.02since 2024-01-01——Plans negotiate; applies out of network—Appendix DD to OAC 5160-1-60 (Non-Instit
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$735.14since 2026-07-01——Not classified—Health First Colorado Physician Fee Sche
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$481.40since 2026-02-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service)$145.40since 2023-10-01unit—Plans negotiate; applies out of network—eMedNY Physician Fee Schedule Sect 4 (Ra
MontanaIndependent (non-agency) provider · Montana Medicaid and HMK Plus (fee-for-service)$121.60since 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)$106.31since 2024-05-20——Plans must pay at least this—Provider Type 77 Physician's Assistant R
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$102.16since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Clinical
UtahPhysician or licensed psychologist (incl. BCBA-D) · Utah Medicaid (fee-for-service, Traditional plan)$93.14since 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$86.02since 2023-07-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$80.07since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$74.94since 2026-07-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical3.csv
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$74.08since 2020-01-01——Plans negotiate; applies out of network—KY Medicaid Physician fee schedule (2020
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$72.40since 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - CPT Code
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$70.12since 2026-01-01——Plans negotiate; applies out of network—Radiology Fee Schedule (2026-01-01)
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$66.89since 2022-07-01——Plans must pay at least this—MO HealthNet fee schedule: Radiology - P
ArkansasPhysician or licensed psychologist (incl. BCBA-D) · Arkansas Medicaid (fee-for-service)$65.68since 2025-06-13——Not classified—Arkansas Medicaid Physician / CRNA / Fam
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$64.60since 2026-10-01——Plans negotiate; applies out of network—Emergency Adoption (date filed: Septembe
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$64.24since 2024-07-01——Not classified—SCDHHS Base Physician Fee Schedule (sche
MichiganIndependent (non-agency) provider · Michigan Medicaid (fee-for-service)$55.17since 2025-01-01——Plans negotiate; applies out of network—MDHHS Independent Diagnostic Testing Fac
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$5.70since 2024-01-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched

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 78431?

It depends on the state. Of the 34 states with a published fee-for-service rate, the median is $313.40. Nebraska pays the most ($3,907.20) and Kansas the least ($5.70).

Which state pays the highest Medicaid rate for 78431?

Nebraska, at $3,907.20, effective 2026-07-01.

Do managed-care plans pay the same rate for 78431?

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 Radiology codes

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Medicaid rates by state
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