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86890 Medicaid reimbursement rates by state

Clinical lab tests. 21 state Medicaid programs publish a fee-for-service rate for 86890 at the physician psychologist level. Rates run from $10.03 in Louisiana to $153.58 in Missouri, with a median of $44.32.

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

States publishing
21
Median rate
$44.32units vary by state
Highest
$153.58Missouri
Medicare (non-facility)
—not on the physician fee schedule

86890 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
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$153.58⚠ over 3× mediansince 2026-07-01——Plans must pay at least this—MO HealthNet fee schedule: Outpatient Ho
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$83.16since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$75.00since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
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
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$60.80since 2015-01-01——Not classified—CMAP fee schedule: Lab October 2026
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$53.15since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$52.00since 2026-04-10——Not classified—Laboratory and Radiology Fee Schedule (R
NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$50.65since 2017-01-01——Plans negotiate; applies out of network—Provider Type 43, Laboratory, Pathology
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$49.00since 2025-03-26——Not classified—Arkansas Medicaid Independent Laboratory
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$48.28since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$44.32since 2023-04-01——Plans negotiate; applies out of network—BMS CY 2023 Clinical Lab Fee Schedule (a
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$41.67since 1996-01-25——Plans must pay at least this—DOM Comprehensive Fee Schedule, June 202
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$39.31since 2013-01-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$38.21since 2025-09-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$38.07since 2013-07-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$32.95since 2024-03-04——Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$26.28since 2023-07-01——Plans negotiate; applies out of network—2026 Fee Schedule - Covered Procedures R
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$23.43since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Clinical
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$20.50since 1993-04-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$12.14since 2018-01-01——Plans negotiate; applies out of network—ODM laboratory services payment schedule
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$10.03since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Laboratory and Radiol

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 86890?

It depends on the state. Of the 21 states with a published fee-for-service rate, the median is $44.32. Missouri pays the most ($153.58) and Louisiana the least ($10.03).

Which state pays the highest Medicaid rate for 86890?

Missouri, at $153.58, effective 2026-07-01.

Do managed-care plans pay the same rate for 86890?

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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