90863 Medicaid reimbursement rates by state
Outpatient psychotherapy and diagnostic evaluation. 13 state Medicaid programs publish a fee-for-service rate for 90863 at the physician psychologist level. Rates run from $13.46 in South Carolina to $67.00 in Alabama, with a median of $36.98.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 13
- Median rate
- $36.98units vary by state
- Highest
- $67.00Alabama
- Medicare (non-facility)
- —not on the physician fee schedule
90863 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 |
|---|---|---|---|---|---|---|
| AlabamaPhysician or licensed psychologist (incl. BCBA-D) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $67.00since 2026-09-24 | — | — | Not classified | — | Teaching Facility Fee Schedule |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $57.14since 2025-01-01 | — | — | Plans must pay at least this | — | Fee Schedule for Behavioral Health Provi |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $50.96since 2022-07-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $42.00since 2025-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service) | $41.32since 2025-10-01 | unit | — | Plans negotiate; applies out of network | — | eMedNY Physician Fee Schedule Sect 2 (Me |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $38.53since 2015-07-01 | — | — | Plans must pay at least this | — | Provider Type 77 Physician's Assistant R |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $36.98since 2013-01-10 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file cptmedical4.csv |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $32.90since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| LouisianaPhysician or licensed psychologist (incl. BCBA-D) · Louisiana Residential Options Waiver (ROW, OCDD/OIDD 1915(c) waiver) | $31.25since 2025-11-18 | 15 min | $125.00 | Paid by the state, outside plans | — | Residential Options Waiver rate and proc |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $22.04since 2025-12-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| ColoradoAny qualified provider (rate does not vary by provider) · Colorado behavioral health services paid fee-for-service by HCPF (outside the RAE capitation) | $20.51since 2026-07-01 | — | — | Paid by the state, outside plans | — | Behavioral Health Fee-for-Service Rates |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $20.15since 2024-01-01 | — | — | Plans expected to pay at least this | — | Appendix DD to OAC 5160-1-60 (Non-Instit |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $13.46since 2024-07-01 | — | — | Plans negotiate; applies out of network | — | SCDHHS Nurse Midwives Fee Schedule (sche |
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 90863?
It depends on the state. Of the 13 states with a published fee-for-service rate, the median is $36.98. Alabama pays the most ($67.00) and South Carolina the least ($13.46).
Which state pays the highest Medicaid rate for 90863?
Alabama, at $67.00, effective 2026-09-24.
Do managed-care plans pay the same rate for 90863?
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.