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86930 Medicaid reimbursement rates by state

Clinical lab tests. 16 state Medicaid programs publish a fee-for-service rate for 86930 at the physician psychologist level. Rates run from $3.90 in Virginia to $252.83 in Kansas, with a median of $39.56.

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

States publishing
16
Median rate
$39.56units vary by state
Highest
$252.83Kansas
Medicare (non-facility)
—not on the physician fee schedule

86930 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)$153.58⚠ over 3× mediansince 2026-07-01——Plans must pay at least this—MO HealthNet fee schedule: Outpatient Ho
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$76.00since 2015-01-01——Not classified—CMAP fee schedule: Lab October 2026
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
NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$59.56since 2017-01-01——Plans negotiate; applies out of network—Provider Type 43, Laboratory, Pathology
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$52.09since 2020-05-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, June 202
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$40.31since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$40.00since 2026-04-10——Not classified—Laboratory and Radiology Fee Schedule (R
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$39.11since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Clinical
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$32.00since 2025-03-26——Not classified—Arkansas Medicaid Independent Laboratory
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$23.06since 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)$21.45since 2018-01-01——Plans negotiate; applies out of network—ODM laboratory services payment schedule
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$14.80since 2026-01-01——Plans negotiate; applies out of network—Practitioner Laboratory Fee Schedule (20
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$9.66since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$9.39since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Laboratory and Radiol
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$3.90since 1993-01-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical4.csv

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 86930?

It depends on the state. Of the 16 states with a published fee-for-service rate, the median is $39.56. Kansas pays the most ($252.83) and Virginia the least ($3.90).

Which state pays the highest Medicaid rate for 86930?

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

Do managed-care plans pay the same rate for 86930?

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 86930 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
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