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81403 Medicaid reimbursement rates by state

Clinical lab tests. 38 state Medicaid programs publish a fee-for-service rate for 81403 at the physician psychologist level. Rates run from $13.50 in Arizona to $519.34 in Kansas, with a median of $166.68.

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

States publishing
38
Median rate
$166.68units vary by state
Highest
$519.34Kansas
Medicare (non-facility)
—not on the physician fee schedule

81403 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
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$519.34⚠ over 3× mediansince 2013-01-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$222.24since 2024-11-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$200.01since 2019-07-04——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$188.00since 2017-01-01——Plans negotiate; applies out of network—Lab Max Allowable (in Zipped 2017 Fee Sc
MontanaIndependent (non-agency) provider · Montana Medicaid and HMK Plus (fee-for-service)$185.20since 2018-07-01——Not classified—Montana Healthcare Programs fee schedule
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$185.20since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$185.20since 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)$185.20since 2020-10-01unit—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)$185.20since 2018-01-01——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)$185.20since 2020-01-01——Plans negotiate; applies out of network—KY Medicaid Clinical Lab fee schedule (2
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$185.20since 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)$185.20since 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)$185.20since 2019-12-01——Not classified—South Dakota Medicaid Laboratory fee sch
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$184.65since 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$180.57since 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)$177.70since 2022-06-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$166.68since 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)$166.68since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$166.68since 2023-04-01——Plans negotiate; applies out of network—BMS CY 2023 Clinical Lab Fee Schedule (a
WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health)$166.68since 2025-09-01——Not classified—Wyoming Medicaid Downloadable Fee Schedu
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$164.73since 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)$163.32since 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)$154.27since 2026-07-01——Not classified—Clinical Diagnostic Laboratory Test (CDL
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$153.35since 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)$148.16since 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$148.16since 2026-01-01——Plans may pay no more—HCA Physician-related services fee sched
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$148.16since 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)$147.23since 2026-01-01——Not classified—Maryland Medicaid Medical Laboratory Fee
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$144.46since 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)$138.90since 2019-04-01——Plans negotiate; applies out of network—ODM laboratory services payment schedule
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$129.89since 2025-09-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$129.64since 2018-01-01——Not classified—CMAP fee schedule: Lab October 2026
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$129.64since 2018-01-01——Not classified—MaineCare Fee Schedule (MaineCare UCR, H
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$126.14since 2024-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$125.76since 2025-03-26——Not classified—Arkansas Medicaid Independent Laboratory
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$116.79since 2013-05-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical4.csv
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$54.94since 2026-01-01——Plans negotiate; applies out of network—Independent Laboratory Fee Schedule (202
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$13.50since 2021-10-01A—Plans negotiate; applies out of network—AHCCCS Arizona Health Care Cost Containm

Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 81403?

It depends on the state. Of the 38 states with a published fee-for-service rate, the median is $166.68. Kansas pays the most ($519.34) and Arizona the least ($13.50 per A).

Which state pays the highest Medicaid rate for 81403?

Kansas, at $519.34, effective 2013-01-01.

Do managed-care plans pay the same rate for 81403?

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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