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80168 Medicaid reimbursement rates by state

Clinical lab tests. 25 state Medicaid programs publish a fee-for-service rate for 80168 at the physician psychologist level. Rates run from $8.17 in Florida to $20.55 in Georgia, with a median of $14.71.

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

States publishing
25
Median rate
$14.71units vary by state
Highest
$20.55Georgia
Medicare (non-facility)
—not on the physician fee schedule

80168 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
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$20.55since 2017-01-01——Plans negotiate; applies out of network—Lab Max Allowable (in Zipped 2017 Fee Sc
North CarolinaPhysician or licensed psychologist (incl. BCBA-D) · North Carolina Medicaid Direct (fee-for-service)$20.16since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Physician Serv
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$17.64since 2021-11-17——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$16.34since 2020-01-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$16.34since 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)$16.34since 2020-01-01unit—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)$16.34since 2020-01-01——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)$16.34since 2020-01-01——Plans negotiate; applies out of network—KY Medicaid Clinical Lab fee schedule (2
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$16.27since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Laboratory and Radiol
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$16.04since 2026-02-01——Not classified—Maryland Medicaid Medical Laboratory Fee
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$15.70since 2014-07-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical4.csv
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$14.71since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Clinical
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$14.71since 2026-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Independent L
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$14.52since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$14.41since 2024-09-01——Plans negotiate; applies out of network—Rates for Clinical Laboratory Services (
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$13.61since 2026-07-01——Not classified—Clinical Diagnostic Laboratory Test (CDL
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$13.53since 2023-01-01——Plans negotiate; applies out of network—MDHHS Clinical Laboratory Fee Schedule,
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$13.07since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$13.07since 2026-01-01——Plans negotiate; applies out of network—HCA Kidney centers fee schedule (kidneyc
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$13.00since 2009-04-02——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$12.75since 2024-07-01——Not classified—SCDHHS Independent Lab and Radiology Fee
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$12.26since 2021-01-01——Plans negotiate; applies out of network—ODM laboratory services payment schedule
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$11.13since 2024-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
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)$8.17since 2026-01-01——Plans negotiate; applies out of network—Practitioner Laboratory Fee Schedule (20

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 80168?

It depends on the state. Of the 25 states with a published fee-for-service rate, the median is $14.71. Georgia pays the most ($20.55) and Florida the least ($8.17).

Which state pays the highest Medicaid rate for 80168?

Georgia, at $20.55, effective 2017-01-01.

Do managed-care plans pay the same rate for 80168?

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.

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