80359 Medicaid reimbursement rates by state
Clinical lab tests. 9 state Medicaid programs publish a fee-for-service rate for 80359 at the physician psychologist level. Rates run from $4.19 in Arizona to $22.05 in New Jersey, with a median of $12.45.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 9
- Median rate
- $12.45units vary by state
- Highest
- $22.05New Jersey
- Medicare (non-facility)
- —not on the physician fee schedule
80359 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.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $22.05since 2023-12-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing Outpatie |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $21.35since 2025-03-26 | — | — | Not classified | — | Arkansas Medicaid Independent Laboratory |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $19.20since 2015-01-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $15.45since 2016-01-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $12.45since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Practitioner Laboratory Fee Schedule (20 |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $10.12since 2019-07-17 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $8.33since 2015-01-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file cptmedical4.csv |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $5.05since 2020-05-29 | — | — | Plans negotiate; applies out of network | — | eMedNY NYS Medicaid Laboratory Fee Sched |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $4.19since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Clinical |
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 80359?
It depends on the state. Of the 9 states with a published fee-for-service rate, the median is $12.45. New Jersey pays the most ($22.05) and Arizona the least ($4.19).
Which state pays the highest Medicaid rate for 80359?
New Jersey, at $22.05, effective 2023-12-01.
Do managed-care plans pay the same rate for 80359?
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.