87812 Medicaid reimbursement rates by state
Clinical lab tests. 29 state Medicaid programs publish a fee-for-service rate for 87812 at the physician psychologist level. Rates run from $44.69 in Texas to $74.48 in California, with a median of $66.25.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 29
- Median rate
- $66.25units vary by state
- Highest
- $74.48California
- Medicare (non-facility)
- —not on the physician fee schedule
87812 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 |
|---|---|---|---|---|---|---|
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $74.48since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $74.48since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $74.48since 2026-06-01 | — | — | 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) | $74.48since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Clinical Lab fee schedule (2 |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $74.48since 2026-03-27 | — | — | Not classified | — | Arkansas Medicaid Independent Laboratory |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service | $74.48since 2026-06-01 | — | — | Plans negotiate; applies out of network | — | Medicaid Fee-For-Service (FFS) Fee Sched |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $74.48since 2026-01-01 | — | — | Not classified | — | South Dakota Medicaid Laboratory fee sch |
| MontanaIndependent (non-agency) provider · Montana Medicaid and HMK Plus (fee-for-service) | $74.47since 2026-01-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $74.26since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $72.62since 2026-01-01 | — | — | Not classified | — | Vermont Medicaid Fee Schedule - CPT Code |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $67.03since 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) | $67.03since 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) | $67.03since 2026-01-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, June 202 |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $67.03since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | BMS CY 2026 New Procedure Codes |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $66.25since 2026-01-01 | — | — | Plans must pay at least this | — | SoonerCare Title XIX Fee Schedule |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $64.35since 2026-07-01 | — | — | 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) | $63.31since 2026-01-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $61.67since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Child and Adolescent Health Center |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $59.58since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Lab Max Allowable January 2026 (in Zippe |
| PennsylvaniaRegistered nurse (RN) · Pennsylvania Medical Assistance (fee-for-service) | $59.58since 2026-08-01 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $59.58since 2026-01-01 | — | — | Plans may pay no more | — | HCA Physician-related services fee sched |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $59.58since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $59.21since 2026-08-01 | — | — | Not classified | — | Maryland Medicaid Medical Laboratory Fee |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $58.39since 2026-07-01 | — | — | Not classified | — | Clinical Diagnostic Laboratory Test (CDL |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $55.86since 2026-04-01 | — | — | Plans negotiate; applies out of network | — | ODM laboratory services payment schedule |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $52.13since 2026-01-01 | — | — | Not classified | — | CMAP fee schedule: Lab October 2026 |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $50.73since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service) | $44.69since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | RI Medicaid Interactive Fee For Service |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $44.69since 2019-07-04 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
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 87812?
It depends on the state. Of the 29 states with a published fee-for-service rate, the median is $66.25. California pays the most ($74.48) and Texas the least ($44.69).
Which state pays the highest Medicaid rate for 87812?
California, at $74.48, effective 2026-10-01.
Do managed-care plans pay the same rate for 87812?
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
80051Clinical lab tests · 48 states80053Clinical lab tests · 48 states80061Clinical lab tests · 48 states80069Clinical lab tests · 48 states80076Clinical lab tests · 48 states80150Clinical lab tests · 48 states80156Clinical lab tests · 48 states80157Clinical lab tests · 48 states80158Clinical lab tests · 48 states80159Clinical lab tests · 48 states80162Clinical lab tests · 48 states80164Clinical lab tests · 48 states
Track 87812 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.