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81459 Medicaid reimbursement rates by state

Clinical lab tests. 23 state Medicaid programs publish a fee-for-service rate for 81459 at the physician psychologist level. Rates run from $0.00 in Arkansas to $3,228.71 in Texas, with a median of $2,391.88.

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

States publishing
23
Median rate
$2,391.88units vary by state
Highest
$3,228.71Texas
Medicare (non-facility)
—not on the physician fee schedule

81459 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
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$3,228.71since 2026-03-13——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$2,989.55since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Clinical
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$2,989.55since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$2,989.55since 2026-01-12unit—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)$2,989.55since 2025-01-01——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)$2,989.55since 2025-01-01——Plans negotiate; applies out of network—KY Medicaid Clinical Lab fee schedule (2
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$2,690.60since 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)$2,690.60since 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)$2,659.16since 2026-01-01——Plans must pay at least this—SoonerCare Title XIX Fee Schedule
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$2,630.80since 2025-01-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical4.csv
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$2,475.35since 2025-01-01——Plans negotiate; applies out of network—MDHHS Clinical Laboratory Fee Schedule,
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$2,391.88since 2024-05-28——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$2,391.64since 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$2,391.64since 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)$2,391.64since 2025-01-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$2,242.16since 2025-04-01——Plans negotiate; applies out of network—ODM laboratory services payment schedule
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$2,125.85since 2024-01-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$2,092.69since 2025-01-01——Not classified—CMAP fee schedule: Lab October 2026
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$2,036.19since 2025-01-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$1,614.36since 2026-01-01——Plans negotiate; applies out of network—Independent Laboratory Fee Schedule (202
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$1,045.85since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Laboratory' -
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$588.02since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$0.00since 2025-03-26——Not classified—Arkansas Medicaid Independent Laboratory

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 81459?

It depends on the state. Of the 23 states with a published fee-for-service rate, the median is $2,391.88. Texas pays the most ($3,228.71) and Arkansas the least ($0.00).

Which state pays the highest Medicaid rate for 81459?

Texas, at $3,228.71, effective 2026-03-13.

Do managed-care plans pay the same rate for 81459?

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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