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88738 Medicaid reimbursement rates by state

Clinical lab tests. 23 state Medicaid programs publish a fee-for-service rate for 88738 at the physician psychologist level. Rates run from $3.77 in Ohio to $6.89 in Iowa, with a median of $4.52.

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

States publishing
23
Median rate
$4.52units vary by state
Highest
$6.89Iowa
Medicare (non-facility)
—not on the physician fee schedule

88738 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)$6.89since 2013-07-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$6.34since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Clinical Pharm
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$5.52since 2017-01-01——Plans negotiate; applies out of network—Lab Max Allowable (in Zipped 2017 Fee Sc
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$5.02since 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)$5.02since 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)$5.02since 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)$5.02since 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)$5.02since 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)$5.02since 2020-01-01——Plans negotiate; applies out of network—KY Medicaid Clinical Lab fee schedule (2
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$4.92since 2026-02-01——Not classified—Maryland Medicaid Medical Laboratory Fee
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$4.79since 2015-01-01——Not classified—CMAP fee schedule: Lab October 2026
ArizonaClinical nurse specialist · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$4.52since 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)$4.52since 2026-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Independent L
PennsylvaniaRegistered nurse (RN) · Pennsylvania Medical Assistance (fee-for-service)$4.47since 2018-02-26——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$4.43since 2024-09-01——Plans negotiate; applies out of network—Rates for Clinical Laboratory Services (
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$4.28since 2010-01-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$4.27since 2025-07-01——Plans must pay at least this—Louisiana Medicaid Laboratory and Radiol
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$4.18since 2026-07-01——Not classified—Clinical Diagnostic Laboratory Test (CDL
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$4.16since 2023-01-01——Plans negotiate; applies out of network—MDHHS Child and Adolescent Health Center
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$4.02since 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$4.02since 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)$3.92since 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)$3.77since 2021-04-01——Plans negotiate; applies out of network—ODM laboratory services payment schedule

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 88738?

It depends on the state. Of the 23 states with a published fee-for-service rate, the median is $4.52. Iowa pays the most ($6.89) and Ohio the least ($3.77).

Which state pays the highest Medicaid rate for 88738?

Iowa, at $6.89, effective 2013-07-01.

Do managed-care plans pay the same rate for 88738?

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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