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80369 Medicaid reimbursement rates by state

Clinical lab tests. 10 state Medicaid programs publish a fee-for-service rate for 80369 at the physician psychologist level. Rates run from $3.66 in Arizona to $26.76 in Arkansas, with a median of $14.89.

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

States publishing
10
Median rate
$14.89units vary by state
Highest
$26.76Arkansas
Medicare (non-facility)
—not on the physician fee schedule

80369 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
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$26.76since 2025-03-26——Not classified—Arkansas Medicaid Independent Laboratory
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$22.17since 2017-01-01——Plans negotiate; applies out of network—Lab Max Allowable (in Zipped 2017 Fee Sc
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$20.96since 2023-12-01——Not classified—NJMMIS Procedure Master Listing Outpatie
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$19.18since 2015-09-01——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$16.43since 2016-01-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$13.35since 2019-07-17——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$13.20since 2026-01-01——Plans negotiate; applies out of network—Practitioner Laboratory Fee Schedule (20
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$10.00since 2015-01-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
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
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$3.66since 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 80369?

It depends on the state. Of the 10 states with a published fee-for-service rate, the median is $14.89. Arkansas pays the most ($26.76) and Arizona the least ($3.66).

Which state pays the highest Medicaid rate for 80369?

Arkansas, at $26.76, effective 2025-03-26.

Do managed-care plans pay the same rate for 80369?

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

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