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87220 Medicaid reimbursement rates by state

Clinical lab tests. 34 state Medicaid programs publish a fee-for-service rate for 87220 at the physician psychologist level. Rates run from $1.72 in New Jersey to $6.06 in Iowa, with a median of $3.87.

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

States publishing
34
Median rate
$3.87units vary by state
Highest
$6.06Iowa
Medicare (non-facility)
—not on the physician fee schedule

87220 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
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$6.06since 2013-07-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$5.36since 2017-01-01——Plans negotiate; applies out of network—Lab Max Allowable (in Zipped 2017 Fee Sc
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$5.26since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Clinical Pharm
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$5.12since 2023-07-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$4.94since 2025-03-26——Not classified—Arkansas Medicaid Independent Laboratory
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$4.61since 2021-11-17——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Chronic Disease Program (adult cystic fibrosis, hemophilia home care, chronic renal disease; state-funded)$4.41since 2020-01-01——Not classified—ForwardHealth max fee schedule: Adult Cy
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$4.27since 2024-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$4.27since 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)$4.27since 2020-01-01unit—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)$4.27since 2020-01-01——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)$4.27since 2020-01-01——Plans negotiate; applies out of network—KY Medicaid Clinical Lab fee schedule (2
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$4.24since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Laboratory and Radiol
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$4.19since 2026-02-01——Not classified—Maryland Medicaid Medical Laboratory Fee
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$4.07since 2015-01-01——Not classified—CMAP fee schedule: Lab October 2026
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$3.90since 2009-03-31——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$3.90since 1987-07-01——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)$3.84since 2026-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Independent L
ArizonaClinical nurse specialist · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$3.84since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Clinical
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$3.84since 2022-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, May 2023
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$3.80since 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)$3.77since 2024-09-01——Plans negotiate; applies out of network—Rates for Clinical Laboratory Services (
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$3.73since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$3.56since 2026-07-01——Not classified—Clinical Diagnostic Laboratory Test (CDL
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$3.53since 2023-01-01——Plans negotiate; applies out of network—MDHHS Child and Adolescent Health Center
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$3.42since 2026-01-01——Plans negotiate; applies out of network—HCA Kidney centers fee schedule (kidneyc
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$3.42since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$3.33since 2024-07-01——Not classified—SCDHHS Independent Lab and Radiology Fee
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$3.20since 2021-04-01——Plans negotiate; applies out of network—ODM laboratory services payment schedule
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$2.98since 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)$2.91since 2017-01-01——Plans negotiate; applies out of network—Provider Type 43, Laboratory, Pathology
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$2.05since 2026-01-01——Plans negotiate; applies out of network—Practitioner Laboratory Fee Schedule (20
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$2.00since 2014-07-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical4.csv
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$1.72since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS

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 87220?

It depends on the state. Of the 34 states with a published fee-for-service rate, the median is $3.87. Iowa pays the most ($6.06) and New Jersey the least ($1.72).

Which state pays the highest Medicaid rate for 87220?

Iowa, at $6.06, effective 2013-07-01.

Do managed-care plans pay the same rate for 87220?

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 87220 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
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