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88172 Medicaid reimbursement rates by state

Clinical lab tests. 40 state Medicaid programs publish a fee-for-service rate for 88172 at the physician psychologist level. Rates run from $18.43 in Nevada to $56.30 in Arizona, with a median of $28.37.

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

States publishing
40
Median rate
$28.37units vary by state
Highest
$56.30Arizona
Medicare (non-facility)
$49.41–$69.992026 physician fee schedule

88172 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
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$56.30since 2026-10-01——Plans negotiate; applies out of network—AHCCCS Arizona Health Care Cost Containm
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$54.88since 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$52.89since 2025-03-26——Not classified—Arkansas Medicaid Independent Laboratory
MontanaIndependent (non-agency) provider · Montana Medicaid and HMK Plus (fee-for-service)$46.48since 2026-07-01——Not classified—Montana Healthcare Programs fee schedule
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$40.64since 2023-07-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$35.53since 2024-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$35.41since 2024-07-01——Not classified—SCDHHS Pediatric Subspecialty and Neonat
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$33.43since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$33.08since 2013-07-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$32.32since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$32.31since 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$31.76since 2017-01-01——Plans negotiate; applies out of network—Lab Max Allowable (in Zipped 2017 Fee Sc
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$31.64since 2026-02-01——Not classified—Maryland Medicaid Medical Laboratory Fee
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$31.52since 2026-01-01——Plans must pay at least this—Louisiana Medicaid Enhanced Professional
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$30.00since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$29.85since 2026-07-01——Plans must pay at least this—SoonerCare Title XIX Fee Schedule
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$29.31since 2026-07-01——Plans must pay at least this—MO HealthNet fee schedule: Independent L
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$28.91since 2021-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$28.65since 2026-07-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical4.csv
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$28.39since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Chronic Disease Program (adult cystic fibrosis, hemophilia home care, chronic renal disease; state-funded)$28.35since 2006-10-01——Not classified—ForwardHealth max fee schedule: Adult Cy
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$28.29since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$28.14since 2023-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$27.85since 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - CPT Code
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$27.70since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$27.65since 2019-04-01——Plans negotiate; applies out of network—ODM laboratory services payment schedule
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$26.68since 2026-02-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$26.56since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$25.93since 2026-10-01——Plans negotiate; applies out of network—Emergency Adoption (date filed: Septembe
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$25.90since 2026-01-01——Plans negotiate; applies out of network—Practitioner Laboratory Fee Schedule (20
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$25.25since 2026-01-01——Plans negotiate; applies out of network—KY Medicaid Clinical Lab fee schedule (2
North CarolinaPhysician or licensed psychologist (incl. BCBA-D) · North Carolina Medicaid Direct (fee-for-service)$24.12since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Physician Serv
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$22.94since 2026-04-01——Plans negotiate; applies out of network—BMS RBRVS 2026 Effective 4/1/26 - 3/31/2
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$22.32since 2026-04-10——Not classified—Laboratory and Radiology Fee Schedule (R
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$21.90since 2023-07-01——Plans negotiate; applies out of network—2026 Fee Schedule - Covered Procedures R
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$21.09since 2026-01-01——Plans negotiate; applies out of network—MDHHS Clinical Laboratory Fee Schedule,
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$20.91since 2026-01-01——Not classified—CMAP fee schedule: Lab October 2026
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$19.91since 2016-01-02——Not classified—MaineCare Fee Schedule (MaineCare UCR, H
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$19.87since 2026-07-01——Plans negotiate; applies out of network—HCA Kidney centers fee schedule (kidneyc
NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$18.43since 2017-01-01——Plans negotiate; applies out of network—Provider Type 43, Laboratory, Pathology

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 88172?

It depends on the state. Of the 40 states with a published fee-for-service rate, the median is $28.37. Arizona pays the most ($56.30) and Nevada the least ($18.43).

Which state pays the highest Medicaid rate for 88172?

Arizona, at $56.30, effective 2026-10-01.

Do managed-care plans pay the same rate for 88172?

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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