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87253 Medicaid reimbursement rates by state

Clinical lab tests. 50 state Medicaid programs publish a fee-for-service rate for 87253 at the physician psychologist level. Rates run from $9.69 in Florida to $28.84 in Arkansas, with a median of $18.86.

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

States publishing
50
Median rate
$18.86units vary by state
Highest
$28.84Arkansas
Medicare (non-facility)
—not on the physician fee schedule

87253 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
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$28.84since 2025-03-26——Not classified—Arkansas Medicaid Independent Laboratory
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$26.48since 2009-03-31——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health)$24.77since 2021-01-01——Not classified—Wyoming Medicaid Downloadable Fee Schedu
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$24.24since 2023-07-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$21.81since 2021-11-17——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$20.48since 2018-10-01——Plans negotiate; applies out of network—Lab Max Allowable (in Zipped 2018 Fee Sc
MontanaIndependent (non-agency) provider · Montana Medicaid and HMK Plus (fee-for-service)$20.20since 2020-01-01——Not classified—Montana Healthcare Programs fee schedule
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$20.20since 2020-01-01——Plans negotiate; applies out of network—KY Medicaid Clinical Lab fee schedule (2
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$20.20since 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)$20.20since 2020-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$20.20since 2020-05-29——Plans negotiate; applies out of network—eMedNY NYS Medicaid Laboratory Fee Sched
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$20.20since 2020-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$20.20since 2020-01-01——Not classified—MaineCare Fee Schedule (MaineCare UCR, H
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$20.20since 2026-06-01——Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched
AlaskaPhysician or licensed psychologist (incl. BCBA-D) · Alaska Medicaid (fee-for-service, Department of Health)$20.20since 2026-07-01——Not classified—Alaska Medicaid Independent Laboratory F
South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services)$20.20since 2020-01-01——Not classified—South Dakota Medicaid Laboratory fee sch
North DakotaAny qualified provider (rate does not vary by provider) · North Dakota Medicaid (fee-for-service)$20.20since 2025-01-01——Not classified—ND Medicaid Professional Services Fee Sc
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$20.14since 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$20.10since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Laboratory and Radiol
North CarolinaPhysician or licensed psychologist (incl. BCBA-D) · North Carolina Medicaid Direct (fee-for-service)$20.09since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Physician Serv
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$19.83since 2026-02-01——Not classified—Maryland Medicaid Medical Laboratory Fee
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$19.80since 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)$19.70since 2025-01-01——Not classified—Vermont Medicaid Fee Schedule - CPT Code
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Chronic Disease Program (adult cystic fibrosis, hemophilia home care, chronic renal disease; state-funded)$19.48since 2006-10-01——Not classified—ForwardHealth max fee schedule: Adult Cy
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$19.29since 2015-01-01——Not classified—CMAP fee schedule: Lab October 2026
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$18.43since 1986-10-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical4.csv
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$18.18since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Clinical
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$18.18since 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)$18.18since 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)$18.18since 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)$17.97since 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)$17.81since 2024-09-01——Plans negotiate; applies out of network—Rates for Clinical Laboratory Services (
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$17.55since 2013-07-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$17.47since 2025-01-01——Plans negotiate; applies out of network—2026 Fee Schedule - Covered Procedures R
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$17.45since 2025-09-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$17.17since 2023-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$16.93since 2003-01-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$16.83since 2026-07-01——Not classified—Clinical Diagnostic Laboratory Test (CDL
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$16.73since 2023-01-01——Plans negotiate; applies out of network—MDHHS Clinical Laboratory Fee Schedule,
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$16.16since 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$16.16since 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)$16.16since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
District of ColumbiaAny qualified provider (rate does not vary by provider) · DC Medicaid (DHCF) fee-for-service$16.16since 2020-04-01——Not classified—REFRP00178CSV - Medical Fee Schedule Rep
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$16.00since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$15.76since 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)$15.15since 2021-04-01——Plans negotiate; applies out of network—ODM laboratory services payment schedule
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$14.59since 2013-01-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$14.14since 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)$13.78since 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)$9.69since 2026-01-01——Plans negotiate; applies out of network—Practitioner Laboratory Fee Schedule (20

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 87253?

It depends on the state. Of the 50 states with a published fee-for-service rate, the median is $18.86. Arkansas pays the most ($28.84) and Florida the least ($9.69).

Which state pays the highest Medicaid rate for 87253?

Arkansas, at $28.84, effective 2025-03-26.

Do managed-care plans pay the same rate for 87253?

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 87253 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
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