90869 Medicaid reimbursement rates by state
Outpatient psychotherapy and diagnostic evaluation. 21 state Medicaid programs publish a fee-for-service rate for 90869 at the physician psychologist level. Rates run from $20.06 in Kansas to $800.37 in California, with a median of $168.89.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 21
- Median rate
- $168.89units vary by state
- Highest
- $800.37California
- Medicare (non-facility)
- —not on the physician fee schedule
90869 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 |
|---|---|---|---|---|---|---|
| CaliforniaPhysician or licensed psychologist (incl. BCBA-D) · California Medi-Cal Specialty Mental Health Services (DHCS fee schedule for county Mental Health Plans) | $800.37⚠ over 3× mediansince 2026-07-01 | — | — | Paid by the state, outside plans | — | Medi-Cal Behavioral Health Fee Schedules |
| MarylandPhysician or licensed psychologist (incl. BCBA-D) · Maryland Public Behavioral Health System (specialty mental health, SUD and ABA, paid fee-for-service through the Carelon ASO) | $576.60⚠ over 3× mediansince 2025-07-01 | — | — | Paid by the state, outside plans | — | FY2026 PBHS Fee Schedule – Individual Pr |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $434.21since 2020-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Physician fee schedule (2020 |
| New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service) | $255.36since 2025-10-01 | unit | — | Plans negotiate; applies out of network | — | eMedNY Physician Fee Schedule Sect 2 (Me |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $249.07since 2026-01-01 | — | — | Not classified | — | CMAP fee schedule: Physician Office and |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $226.61since 2012-01-01 | — | — | Not classified | — | SCDHHS Base Physician Fee Schedule (sche |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $217.48since 2025-04-01 | — | — | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| LouisianaPhysician or licensed psychologist (incl. BCBA-D) · Louisiana Medicaid (fee-for-service) | $192.73since 2024-08-02 | — | — | Plans must pay at least this | — | Specialized Behavioral Health Services f |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $186.50since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Mental health and psychology service |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $186.28since 2026-02-01 | — | — | Plans must pay at least this | — | MHCP Fee Schedule - Current Fee Schedule |
| PennsylvaniaRegistered nurse (RN) · Pennsylvania Medical Assistance (fee-for-service) | $168.89since 2024-05-28 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $144.52since 2024-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $135.70since 2026-07-01 | — | — | Plans must pay at least this | — | DMAS procedure fee file cptmedical4.csv |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $131.77since 2020-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $116.64since 2021-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $111.08since 2022-07-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Practitioner |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $100.04since 2021-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $98.45since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Practitioner and Medical Clinic Fe |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $90.88since 2024-07-01 | unit | — | Plans negotiate; applies out of network | — | OHP FFS behavioral health fee schedule ( |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $79.47since 2022-01-01 | — | — | Plans expected to pay at least this | — | Appendix DD to OAC 5160-1-60 (Non-Instit |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $20.06since 2012-01-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 90869?
It depends on the state. Of the 21 states with a published fee-for-service rate, the median is $168.89. California pays the most ($800.37) and Kansas the least ($20.06).
Which state pays the highest Medicaid rate for 90869?
California, at $800.37, effective 2026-07-01.
Do managed-care plans pay the same rate for 90869?
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 Behavioral health codes
90791Mental health assessment (non-physician) · 32 states90832Outpatient psychotherapy and diagnostic evaluation · 32 states90834Outpatient psychotherapy and diagnostic evaluation · 32 states90837Outpatient psychotherapy and diagnostic evaluation · 32 states90847Outpatient psychotherapy and diagnostic evaluation · 32 states90853Outpatient psychotherapy and diagnostic evaluation · 32 states96110Mental health assessment (non-physician) · 32 states96112Mental health assessment (non-physician) · 32 states96130Mental health assessment (non-physician) · 32 states96131Mental health assessment (non-physician) · 32 states96136Mental health assessment (non-physician) · 32 states96137Mental health assessment (non-physician) · 32 states
Track 90869 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.