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80167 Medicaid reimbursement rates by state

Clinical lab tests. 43 state Medicaid programs publish a fee-for-service rate for 80167 at the physician psychologist level. Rates run from $9.32 in Nevada to $20.13 in Texas, with a median of $16.40.

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

States publishing
43
Median rate
$16.40units vary by state
Highest
$20.13Texas
Medicare (non-facility)
—not on the physician fee schedule

80167 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
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$20.13since 2019-07-04——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
MontanaIndependent (non-agency) provider · Montana Medicaid and HMK Plus (fee-for-service)$18.64since 2021-01-01——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)$18.64since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Clinical
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$18.64since 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)$18.64since 2021-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$18.64since 2021-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$18.64since 2021-01-01——Plans negotiate; applies out of network—KY Medicaid Clinical Lab fee schedule (2
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$18.64since 2025-03-26——Not classified—Arkansas Medicaid Independent Laboratory
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$18.64since 2026-06-01——Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched
AlaskaPhysician or licensed psychologist (incl. BCBA-D) · Alaska Medicaid (fee-for-service, Department of Health)$18.64since 2026-07-01——Not classified—Alaska Medicaid Independent Laboratory F
South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services)$18.64since 2022-01-01——Not classified—South Dakota Medicaid Laboratory fee sch
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$18.58since 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$18.27since 2024-01-01——Plans negotiate; applies out of network—DMAP 2024 Physician Fee Schedule
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$18.17since 2025-01-01——Not classified—Vermont Medicaid Fee Schedule - CPT Code
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$17.71since 2021-01-01——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)$16.96since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Laboratory' -
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$16.78since 2026-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Independent L
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$16.78since 2022-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, May 2023
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$16.78since 2023-04-01——Plans negotiate; applies out of network—BMS CY 2023 Clinical Lab Fee Schedule (a
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$16.58since 2024-01-01——Plans must pay at least this—SoonerCare Title XIX Fee Schedule
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$16.44since 2024-09-01——Plans negotiate; applies out of network—Rates for Clinical Laboratory Services (
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$16.40since 2021-01-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical4.csv
WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health)$16.31since 2021-01-01——Not classified—Wyoming Medicaid Downloadable Fee Schedu
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$16.12since 2025-01-01——Plans negotiate; applies out of network—2026 Fee Schedule - Covered Procedures R
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$16.11since 2025-09-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$15.84since 2025-07-01——Plans must pay at least this—Louisiana Medicaid Laboratory and Radiol
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$15.84since 2021-01-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$15.52since 2026-07-01——Not classified—Clinical Diagnostic Laboratory Test (CDL
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$15.44since 2023-01-01——Plans negotiate; applies out of network—MDHHS Clinical Laboratory Fee Schedule,
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$14.91since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$14.91since 2021-01-01——Plans negotiate; applies out of network—Lab Max Allowable_ (003) (in Zipped Fee
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$14.91since 2021-12-01——Not classified—NJMMIS Procedure Master Listing Outpatie
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$14.91since 2026-01-01——Plans may pay no more—HCA Physician-related services fee sched
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$14.91since 2021-01-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$14.91since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$14.82since 2026-02-01——Not classified—Maryland Medicaid Medical Laboratory Fee
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$13.98since 2021-04-01——Plans negotiate; applies out of network—ODM laboratory services payment schedule
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$13.04since 2026-04-10——Not classified—Laboratory and Radiology Fee Schedule (R
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$12.70since 2024-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$11.18since 2021-01-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$10.61since 2020-05-29——Plans negotiate; applies out of network—eMedNY NYS Medicaid Laboratory Fee Sched
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$10.06since 2026-01-01——Plans negotiate; applies out of network—Independent Laboratory Fee Schedule (202
NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$9.32since 2021-01-01——Plans negotiate; applies out of network—Provider Type 43, Laboratory, Pathology

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 80167?

It depends on the state. Of the 43 states with a published fee-for-service rate, the median is $16.40. Texas pays the most ($20.13) and Nevada the least ($9.32).

Which state pays the highest Medicaid rate for 80167?

Texas, at $20.13, effective 2019-07-04.

Do managed-care plans pay the same rate for 80167?

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 Lab & pathology codes

Track 80167 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
Medicaid rates by state