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86870 Medicaid reimbursement rates by state

Clinical lab tests. 35 state Medicaid programs publish a fee-for-service rate for 86870 at the physician psychologist level. Rates run from $6.12 in Georgia to $252.83 in Kansas, with a median of $20.00.

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

States publishing
35
Median rate
$20.00units vary by state
Highest
$252.83Kansas
Medicare (non-facility)
—not on the physician fee schedule

86870 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)$252.83⚠ over 3× mediansince 2023-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$233.00⚠ over 3× mediansince 2021-01-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Independent L
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$65.07since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$56.29since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Clinical
MontanaIndependent (non-agency) provider · Montana Medicaid and HMK Plus (fee-for-service)$53.46since 2025-07-01——Not classified—Montana Healthcare Programs fee schedule
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$44.02since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$42.50since 2009-01-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$37.25since 1994-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$31.68since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Laboratory and Radiol
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$30.03since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$28.55since 2015-01-01——Not classified—CMAP fee schedule: Lab October 2026
North CarolinaPhysician or licensed psychologist (incl. BCBA-D) · North Carolina Medicaid Direct (fee-for-service)$25.37since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Physician Serv
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$25.08since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$23.42since 2024-01-01——Plans must pay at least this—SoonerCare Title XIX Fee Schedule
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$22.58since 2018-01-01——Plans negotiate; applies out of network—ODM laboratory services payment schedule
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$22.58since 2023-04-01——Plans negotiate; applies out of network—BMS CY 2023 Clinical Lab Fee Schedule (a
NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$22.08since 2017-01-01——Plans negotiate; applies out of network—Provider Type 43, Laboratory, Pathology
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$20.00since 2010-09-01——Not classified—MaineCare Fee Schedule (MaineCare UCR, H
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$17.10since 1993-01-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical4.csv
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$16.52since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$14.24since 2020-05-29——Plans negotiate; applies out of network—eMedNY NYS Medicaid Laboratory Fee Sched
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$14.00since 2026-04-10——Not classified—Laboratory and Radiology Fee Schedule (R
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$13.96since 2013-01-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$13.72since 2023-01-01——Plans negotiate; applies out of network—MDHHS Clinical Laboratory Fee Schedule,
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$13.13since 2020-05-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$12.10since 2025-03-26——Not classified—Arkansas Medicaid Independent Laboratory
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$11.33since 2025-09-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$11.10since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$10.91since 2011-04-08——Not classified—SCDHHS Independent Lab and Radiology Fee
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$9.00since 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)$8.45since 2009-03-31——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$7.67since 2025-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$6.55since 2020-05-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, June 202
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$6.30since 2026-01-01——Plans negotiate; applies out of network—Practitioner Laboratory Fee Schedule (20
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$6.12since 2017-01-01——Plans negotiate; applies out of network—Lab Max Allowable (in Zipped 2017 Fee Sc

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 86870?

It depends on the state. Of the 35 states with a published fee-for-service rate, the median is $20.00. Kansas pays the most ($252.83) and Georgia the least ($6.12).

Which state pays the highest Medicaid rate for 86870?

Kansas, at $252.83, effective 2023-07-01.

Do managed-care plans pay the same rate for 86870?

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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