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86902 Medicaid reimbursement rates by state

Clinical lab tests. 43 state Medicaid programs publish a fee-for-service rate for 86902 at the physician psychologist level. Rates run from $2.74 in Nevada to $6.85 in Texas, with a median of $5.38.

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

States publishing
43
Median rate
$5.38units vary by state
Highest
$6.85Texas
Medicare (non-facility)
—not on the physician fee schedule

86902 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)$6.85since 2019-07-04——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)$6.35since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Clinical
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$6.35since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$6.35since 2024-01-01unit—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)$6.35since 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)$6.35since 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)$6.35since 2023-07-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$6.35since 2026-06-01——Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched
MontanaIndependent (non-agency) provider · Montana Medicaid and HMK Plus (fee-for-service)$6.34since 2018-07-01——Not classified—Montana Healthcare Programs fee schedule
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$6.33since 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$6.22since 2024-01-01——Plans negotiate; applies out of network—DMAP 2024 Physician Fee Schedule
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$6.19since 2025-01-01——Not classified—Vermont Medicaid Fee Schedule - CPT Code
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$5.72since 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)$5.72since 2022-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, May 2023
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$5.72since 2023-04-01——Plans negotiate; applies out of network—BMS CY 2023 Clinical Lab Fee Schedule (a
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$5.65since 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)$5.60since 2024-09-01——Plans negotiate; applies out of network—Rates for Clinical Laboratory Services (
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$5.49since 2025-09-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$5.49since 2025-01-01——Plans negotiate; applies out of network—2026 Fee Schedule - Covered Procedures R
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$5.40since 2025-07-01——Plans must pay at least this—Louisiana Medicaid Laboratory and Radiol
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$5.40since 2023-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$5.38since 2025-03-26——Not classified—Arkansas Medicaid Independent Laboratory
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$5.29since 2026-07-01——Not classified—Clinical Diagnostic Laboratory Test (CDL
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$5.26since 2023-01-01——Plans negotiate; applies out of network—MDHHS Clinical Laboratory Fee Schedule,
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$5.20since 2015-01-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$5.08since 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$5.08since 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)$5.08since 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)$5.05since 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)$4.95since 2024-07-01——Not classified—SCDHHS Independent Lab and Radiology Fee
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$4.77since 2013-07-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$4.76since 2019-04-01——Plans negotiate; applies out of network—ODM laboratory services payment schedule
North CarolinaPhysician or licensed psychologist (incl. BCBA-D) · North Carolina Medicaid Direct (fee-for-service)$4.75since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Physician Serv
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$4.44since 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)$4.33since 2024-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$4.30since 2018-10-01——Plans negotiate; applies out of network—Lab Max Allowable (in Zipped 2018 Fee Sc
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$3.77since 2016-01-02——Not classified—MaineCare Fee Schedule (MaineCare UCR, H
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$3.65since 2015-01-01——Not classified—CMAP fee schedule: Lab October 2026
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$3.28since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$3.23since 2011-01-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$3.09since 2014-07-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical4.csv
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$2.82since 2011-08-08——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$2.74since 2024-01-01——Plans negotiate; applies out of network—Provider Type 20 Physician, MD., Osteopa

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 86902?

It depends on the state. Of the 43 states with a published fee-for-service rate, the median is $5.38. Texas pays the most ($6.85) and Nevada the least ($2.74).

Which state pays the highest Medicaid rate for 86902?

Texas, at $6.85, effective 2019-07-04.

Do managed-care plans pay the same rate for 86902?

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

Track 86902 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
Medicaid rates by state