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86486 Medicaid reimbursement rates by state

Clinical lab tests. 35 state Medicaid programs publish a fee-for-service rate for 86486 at the physician psychologist level. Rates run from $2.95 in Maine to $30.01 in New Hampshire, with a median of $5.02.

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

States publishing
35
Median rate
$5.02units vary by state
Highest
$30.01New Hampshire
Medicare (non-facility)
$5.62–$9.332026 physician fee schedule

86486 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
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$30.01⚠ over 3× mediansince 2020-01-01——Plans negotiate; applies out of network—2026 Fee Schedule - Covered Procedures R
MontanaIndependent (non-agency) provider · Montana Medicaid and HMK Plus (fee-for-service)$9.39since 2026-07-01——Not classified—Montana Healthcare Programs fee schedule
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$6.87since 2026-06-01——Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched
ArizonaPhysician or licensed psychologist (incl. BCBA-D) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$6.70since 2024-10-01——Plans negotiate; applies out of network—AHCCCS Arizona Health Care Cost Containm
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$6.63since 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$5.90since 2023-07-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$5.79since 2026-07-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical4.csv
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$5.74since 2026-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Independent L
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$5.55since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$5.55since 2026-07-01——Plans must pay at least this—SoonerCare Title XIX Fee Schedule
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$5.53since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$5.37since 2026-02-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$5.18since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$5.14since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$5.14since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$5.08since 2023-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service)$5.05since 2023-01-01unit—Plans negotiate; applies out of network—eMedNY Physician Fee Schedule Sect 2 (Me
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$5.02since 2026-10-01——Plans negotiate; applies out of network—Emergency Adoption (date filed: Septembe
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$4.99since 2018-10-01——Plans negotiate; applies out of network—Lab Max Allowable (in Zipped 2018 Fee Sc
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$4.91since 2025-03-26——Not classified—Arkansas Medicaid Independent Laboratory
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$4.77since 2025-07-01——Plans must pay at least this—Louisiana Medicaid Laboratory and Radiol
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$4.76since 2026-02-01——Not classified—Maryland Medicaid Medical Laboratory Fee
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$4.60since 2026-04-01——Plans negotiate; applies out of network—ODM laboratory services payment schedule
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$4.48since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$4.45since 2020-01-01——Plans negotiate; applies out of network—KY Medicaid Physician fee schedule (2020
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$4.41since 2024-07-01——Not classified—SCDHHS Independent Lab and Radiology Fee
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$4.39since 2026-04-01——Plans negotiate; applies out of network—BMS RBRVS 2026 Effective 4/1/26 - 3/31/2
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$4.36since 2013-07-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$4.26since 2026-01-01——Plans negotiate; applies out of network—MDHHS Clinical Laboratory Fee Schedule,
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$4.20since 2026-07-01——Plans negotiate; applies out of network—HCA Kidney centers fee schedule (kidneyc
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$4.02since 2009-12-18——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$3.74since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Clinical Pharm
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$3.71since 2026-04-10——Not classified—Laboratory and Radiology Fee Schedule (R
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$3.15since 2026-01-01——Plans negotiate; applies out of network—Independent Laboratory Fee Schedule (202
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$2.95since 2015-01-01——Not classified—MaineCare Fee Schedule (MaineCare UCR, H

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 86486?

It depends on the state. Of the 35 states with a published fee-for-service rate, the median is $5.02. New Hampshire pays the most ($30.01) and Maine the least ($2.95).

Which state pays the highest Medicaid rate for 86486?

New Hampshire, at $30.01, effective 2020-01-01.

Do managed-care plans pay the same rate for 86486?

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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Medicaid rates by state
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