86985 Medicaid reimbursement rates by state
Clinical lab tests. 23 state Medicaid programs publish a fee-for-service rate for 86985 at the physician psychologist level. Rates run from $1.00 in Kansas to $999.99 in Maine, with a median of $13.50.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 23
- Median rate
- $13.50units vary by state
- Highest
- $999.99Maine
- Medicare (non-facility)
- —not on the physician fee schedule
86985 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.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $999.99⚠ over 3× mediansince 2010-09-01 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| 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 |
| DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP) | $101.80⚠ over 3× mediansince 2024-01-01 | — | — | Plans negotiate; applies out of network | — | DMAP 2024 Physician Fee Schedule |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $28.98since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service CPT |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $27.82since 2013-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $25.00since 2025-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $22.13since 2023-04-01 | — | — | Plans negotiate; applies out of network | — | BMS CY 2023 Clinical Lab Fee Schedule (a |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Chronic Disease Program (adult cystic fibrosis, hemophilia home care, chronic renal disease; state-funded) | $20.43since 2006-10-01 | — | — | Not classified | — | ForwardHealth max fee schedule: Renal Di |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $19.52since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $18.72since 2024-01-01 | — | — | Plans must pay at least this | — | SoonerCare Title XIX Fee Schedule |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $15.96since 2015-01-01 | — | — | Not classified | — | CMAP fee schedule: Lab October 2026 |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $13.50since 2018-01-01 | — | — | Plans negotiate; applies out of network | — | ODM laboratory services payment schedule |
| NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $13.17since 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) | $11.50since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Clinical |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $10.97since 2012-07-01 | — | — | Plans must pay at least this | — | Louisiana Medicaid Laboratory and Radiol |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $10.91since 2020-05-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, June 202 |
| AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $9.00since 2026-04-10 | — | — | Not classified | — | Laboratory and Radiology Fee Schedule (R |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service | $9.00since 2024-03-04 | — | — | Plans negotiate; applies out of network | — | Medicaid Fee-For-Service (FFS) Fee Sched |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $7.98since 2013-01-01 | — | — | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $6.05since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $5.63since 2023-07-01 | — | — | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $5.00since 2025-03-26 | — | — | Not classified | — | Arkansas Medicaid Independent Laboratory |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $1.00since 1993-04-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
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 86985?
It depends on the state. Of the 23 states with a published fee-for-service rate, the median is $13.50. Maine pays the most ($999.99) and Kansas the least ($1.00).
Which state pays the highest Medicaid rate for 86985?
Maine, at $999.99, effective 2010-09-01.
Do managed-care plans pay the same rate for 86985?
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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Track 86985 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.