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78635 Medicaid reimbursement rates by state

Imaging and radiology. 44 state Medicaid programs publish a fee-for-service rate for 78635 at the physician psychologist level. Rates run from $23.48 in Colorado to $374.66 in Montana, with a median of $193.24.

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

States publishing
44
Median rate
$193.24units vary by state
Highest
$374.66Montana
Medicare (non-facility)
$254.92–$415.842026 physician fee schedule

78635 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
MontanaIndependent (non-agency) provider · Montana Medicaid and HMK Plus (fee-for-service)$374.66since 2026-07-01——Not classified—Montana Healthcare Programs fee schedule
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$303.10since 2026-10-01——Plans negotiate; applies out of network—AHCCCS Arizona Health Care Cost Containm
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$281.09since 2025-01-01——Plans negotiate; applies out of network—2026 Fee Schedule - Covered Procedures R
UtahPhysician or licensed psychologist (incl. BCBA-D) · Utah Medicaid (fee-for-service, Traditional plan)$274.65since 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$272.97since 2016-01-01——Plans must pay at least this—Provider Type 77 Physician's Assistant R
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$261.71since 2023-07-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$258.21since 2026-01-01——Not classified—Maryland Medicaid Professional Services
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$257.93since 2026-01-01——Plans negotiate; applies out of network—DMAP 2026 Physician Fee Schedule
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$243.85since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$242.09since 2022-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Radiology - T
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$231.57since 2026-02-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$230.90since 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)$228.73since 2026-10-01——Plans negotiate; applies out of network—Emergency Adoption (date filed: Septembe
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$225.25since 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - CPT Code
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$222.68since 2026-07-01——Plans must pay at least this—SoonerCare Title XIX Fee Schedule
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$217.23since 2026-02-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$211.22since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$208.36since 2024-01-01——Plans negotiate; applies out of network—Appendix DD to OAC 5160-1-60 (Non-Instit
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$207.30since 2026-01-01——Plans negotiate; applies out of network—Radiology Fee Schedule (2026-01-01)
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$206.36since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$199.36since 2026-06-01——Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$196.00since 2025-10-01——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Independent Di
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$190.48since 2024-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$189.82since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$177.18since 2026-01-01——Not classified—MaineCare Fee Schedule (MaineCare UCR, H
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$173.67since 2024-07-01——Plans negotiate; applies out of network—SCDHHS Nurse Midwives Fee Schedule (sche
MichiganIndependent (non-agency) provider · Michigan Medicaid (fee-for-service)$169.97since 2026-01-01——Plans negotiate; applies out of network—MDHHS Independent Diagnostic Testing Fac
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$169.82since 2026-04-01——Plans negotiate; applies out of network—BMS RBRVS 2026 Effective 4/1/26 - 3/31/2
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$167.98since 2026-07-01——Plans negotiate; applies out of network—HCA Physician-related services fee sched
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$149.36since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$138.26since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$103.25since 2025-06-13——Not classified—Arkansas Medicaid Nurse Practitioner Fee
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$101.79since 2015-05-01——Not classified—CMAP fee schedule: Independent Radiology
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$101.42since 2026-04-10——Not classified—Laboratory and Radiology Fee Schedule (R
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$93.26since 2025-07-01——Plans must pay at least this—Louisiana Medicaid Laboratory and Radiol
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$86.88since 2013-07-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$86.86since 2017-01-01——Plans negotiate; applies out of network—Physician Maximum Allowed Fee Schedule -
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$86.26since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$68.80since 2020-01-01——Plans negotiate; applies out of network—KY Medicaid Physician fee schedule (2020
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$65.56since 2024-01-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$54.70since 2000-01-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service)$25.90since 2023-10-01unit—Plans negotiate; applies out of network—eMedNY Physician Fee Schedule Sect 4 (Ra
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$24.14since 2026-03-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$23.48since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee

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 78635?

It depends on the state. Of the 44 states with a published fee-for-service rate, the median is $193.24. Montana pays the most ($374.66) and Colorado the least ($23.48).

Which state pays the highest Medicaid rate for 78635?

Montana, at $374.66, effective 2026-07-01.

Do managed-care plans pay the same rate for 78635?

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
AlabamaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsin