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81415 Medicaid reimbursement rates by state

Clinical lab tests. 28 state Medicaid programs publish a fee-for-service rate for 81415 at the physician psychologist level. Rates run from $480.69 in Kansas to $4,780.00 in Arizona, with a median of $3,890.92.

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

States publishing
28
Median rate
$3,890.92units vary by state
Highest
$4,780.00Arizona
Medicare (non-facility)
—not on the physician fee schedule

81415 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
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$4,780.00since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Clinical
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$4,780.00since 2024-07-01unit—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)$4,780.00since 2018-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$4,780.00since 2018-01-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical4.csv
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$4,780.00since 2020-01-01——Plans negotiate; applies out of network—KY Medicaid Clinical Lab fee schedule (2
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$4,780.00since 2024-11-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$4,586.41since 2024-02-01——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)$4,349.80since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Laboratory' -
TexasIndependent (non-agency) provider · Texas Medicaid (fee-for-service, TMHP)$4,336.41since 2019-07-04——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Labor
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$4,302.00since 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)$4,302.00since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$4,251.74since 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)$4,215.36since 2024-09-01——Plans negotiate; applies out of network—Rates for Clinical Laboratory Services (
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$3,957.84since 2023-01-01——Plans negotiate; applies out of network—MDHHS Clinical Laboratory Fee Schedule,
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$3,824.00since 2023-01-01——Plans negotiate; applies out of network—Lab Max Allowable January 2023 v2 (in Zi
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$3,824.00since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$3,824.00since 2022-08-29——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$3,824.00since 2020-01-01——Plans negotiate; applies out of network—ForwardHealth interactive max fee schedu
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$3,824.00since 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)$3,800.10since 2026-02-01——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)$3,728.40since 2024-12-01——Not classified—SCDHHS Independent Lab and Radiology Fee
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$3,585.00since 2019-04-01——Plans negotiate; applies out of network—ODM laboratory services payment schedule
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$3,346.00since 2018-01-01——Not classified—CMAP fee schedule: Lab October 2026
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$3,255.66since 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)$2,868.00since 2026-06-09——Not classified—Arkansas Medicaid Independent Laboratory
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$2,581.20since 2026-01-01——Plans negotiate; applies out of network—Independent Laboratory Fee Schedule (202
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$958.56since 2026-01-01——Plans may pay no more—HCA Physician-related services fee sched
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$480.69since 2015-01-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched

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 81415?

It depends on the state. Of the 28 states with a published fee-for-service rate, the median is $3,890.92. Arizona pays the most ($4,780.00) and Kansas the least ($480.69).

Which state pays the highest Medicaid rate for 81415?

Arizona, at $4,780.00, effective 2026-10-01.

Do managed-care plans pay the same rate for 81415?

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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