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87485 Medicaid reimbursement rates by state

Clinical lab tests. 24 state Medicaid programs publish a fee-for-service rate for 87485 at the physician psychologist level. Rates run from $9.62 in Florida to $24.80 in Georgia, with a median of $19.60.

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

States publishing
24
Median rate
$19.60units vary by state
Highest
$24.80Georgia
Medicare (non-facility)
—not on the physician fee schedule

87485 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
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$24.80since 2018-10-01——Plans negotiate; applies out of network—Lab Max Allowable (in Zipped 2018 Fee Sc
North CarolinaPhysician or licensed psychologist (incl. BCBA-D) · North Carolina Medicaid Direct (fee-for-service)$24.74since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Physician Serv
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$22.72since 2012-06-25——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$21.65since 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 Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$20.05since 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)$20.05since 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)$20.05since 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)$20.05since 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)$20.05since 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)$20.05since 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)$20.05since 2020-01-01——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)$19.68since 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)$19.51since 2024-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$18.05since 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)$18.05since 2026-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Independent L
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$17.82since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$17.68since 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)$16.70since 2026-07-01——Not classified—Clinical Diagnostic Laboratory Test (CDL
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$16.61since 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)$16.04since 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$16.04since 2026-01-01——Plans may pay no more—HCA Physician-related services fee sched
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$15.64since 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)$15.04since 2021-04-01——Plans negotiate; applies out of network—ODM laboratory services payment schedule
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$9.62since 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 87485?

It depends on the state. Of the 24 states with a published fee-for-service rate, the median is $19.60. Georgia pays the most ($24.80) and Florida the least ($9.62).

Which state pays the highest Medicaid rate for 87485?

Georgia, at $24.80, effective 2018-10-01.

Do managed-care plans pay the same rate for 87485?

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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