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87305 Medicaid reimbursement rates by state

Clinical lab tests. 35 state Medicaid programs publish a fee-for-service rate for 87305 at the physician psychologist level. Rates run from $5.75 in Florida to $16.48 in Iowa, with a median of $11.45.

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

States publishing
35
Median rate
$11.45units vary by state
Highest
$16.48Iowa
Medicare (non-facility)
—not on the physician fee schedule

87305 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)$16.48since 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)$15.08since 2017-01-01——Plans negotiate; applies out of network—Lab Max Allowable (in Zipped 2017 Fee Sc
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$14.38since 2023-07-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$14.13since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Clinical Pharm
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$13.01since 2025-03-26——Not classified—Arkansas Medicaid Independent Laboratory
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$12.93since 2021-11-17——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$12.31since 2008-03-15——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$11.98since 2020-01-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$11.98since 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)$11.98since 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)$11.98since 2020-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$11.98since 2020-01-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical4.csv
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$11.98since 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)$11.98since 2020-01-01——Plans must pay at least this—Louisiana Medicaid Laboratory and Radiol
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$11.98since 2023-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$11.77since 2026-02-01——Not classified—Maryland Medicaid Medical Laboratory Fee
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$11.66since 2024-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$11.45since 2015-01-01——Not classified—CMAP fee schedule: Lab October 2026
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$10.78since 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)$10.78since 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)$10.78since 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)$10.66since 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)$10.56since 2024-09-01——Plans negotiate; applies out of network—Rates for Clinical Laboratory Services (
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$9.98since 2026-07-01——Not classified—Clinical Diagnostic Laboratory Test (CDL
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$9.92since 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)$9.58since 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$9.58since 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)$9.58since 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)$9.34since 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)$8.99since 2021-04-01——Plans negotiate; applies out of network—ODM laboratory services payment schedule
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$8.66since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$8.59since 2024-01-01——Plans negotiate; applies out of network—Provider Type 20 Physician, MD., Osteopa
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$8.38since 2026-04-10——Not classified—Laboratory and Radiology Fee Schedule (R
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$8.11since 2020-05-29——Plans negotiate; applies out of network—eMedNY NYS Medicaid Laboratory Fee Sched
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$5.75since 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 87305?

It depends on the state. Of the 35 states with a published fee-for-service rate, the median is $11.45. Iowa pays the most ($16.48) and Florida the least ($5.75).

Which state pays the highest Medicaid rate for 87305?

Iowa, at $16.48, effective 2013-07-01.

Do managed-care plans pay the same rate for 87305?

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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