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86950 Medicaid reimbursement rates by state

Clinical lab tests. 22 state Medicaid programs publish a fee-for-service rate for 86950 at the physician psychologist level. Rates run from $0.00 in Arkansas to $168.93 in Nebraska, with a median of $41.04.

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

States publishing
22
Median rate
$41.04units vary by state
Highest
$168.93Nebraska
Medicare (non-facility)
—not on the physician fee schedule

86950 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
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$168.93⚠ over 3× mediansince 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$129.47⚠ over 3× mediansince 2023-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$126.55⚠ over 3× mediansince 2025-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, June 202
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$119.32since 2021-01-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Independent L
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$93.98since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$83.19since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$55.00since 1993-01-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical4.csv
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$54.64since 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)$42.85since 2025-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$41.80since 2015-01-01——Not classified—CMAP fee schedule: Lab October 2026
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$41.60since 2026-01-01——Plans negotiate; applies out of network—Practitioner Laboratory Fee Schedule (20
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$40.48since 2013-07-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$38.78since 2017-01-01——Plans negotiate; applies out of network—Provider Type 43, Laboratory, Pathology
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$36.47since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Clinical
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$32.00since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$32.00since 2026-04-10——Not classified—Laboratory and Radiology Fee Schedule (R
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$31.37since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Laboratory and Radiol
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$28.58since 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)$28.58since 2023-04-01——Plans negotiate; applies out of network—BMS CY 2023 Clinical Lab Fee Schedule (a
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$25.01since 2013-01-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$3.74since 2026-01-01——Plans may pay no more—HCA Physician-related services fee sched
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$0.00since 2025-03-26——Not classified—Arkansas Medicaid Independent Laboratory

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 86950?

It depends on the state. Of the 22 states with a published fee-for-service rate, the median is $41.04. Nebraska pays the most ($168.93) and Arkansas the least ($0.00).

Which state pays the highest Medicaid rate for 86950?

Nebraska, at $168.93, effective 2026-07-01.

Do managed-care plans pay the same rate for 86950?

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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