91304 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 38 state Medicaid programs publish a fee-for-service rate for 91304 at the physician psychologist level. Rates run from $2.67 in Washington to $232.22 in Utah, with a median of $174.75.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 38
- Median rate
- $174.75units vary by state
- Highest
- $232.22Utah
- Medicare (non-facility)
- —not on the physician fee schedule
91304 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 |
|---|---|---|---|---|---|---|
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $232.22since 2026-10-01 | — | — | 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) | $232.22since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | PADL-Appendix A- October 2026 COVID-19 & |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $232.22since 2026-08-27 | — | — | Plans negotiate; applies out of network | — | MDHHS Child and Adolescent Health Center |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $232.22since 2026-09-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Transpor |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $232.22since 2026-10-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $232.22since 2026-10-01 | — | — | Not classified | — | South Dakota Medicaid Podiatry fee sched |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $232.22since 2026-10-01 | 0.5 ML | — | Plans negotiate; applies out of network | — | BMS Physician Administered Drug ASP Pric |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $232.21since 2026-08-27 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $200.44since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | SCDHHS Nurse Midwives Fee Schedule (sche |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $191.92since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Prescribed Drugs Immunization Fee Schedu |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $191.92since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $191.92since 2026-07-01 | — | — | Plans must pay at least this | — | Louisiana Medicaid Immunization Fee Sche |
| AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $191.92since 2026-08-25 | — | — | Not classified | — | Physician Drug Fee Schedule (REF-0130-Q) |
| MontanaIndependent (non-agency) provider · Montana Medicaid and HMK Plus (fee-for-service) | $191.92since 2025-10-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $191.91since 2025-08-27 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file cptmedical4.csv |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $191.20since 2026-07-01 | — | — | Not classified | — | Immunization Rates (07/26) |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $182.32since 2026-01-01 | — | — | Not classified | — | Vermont Medicaid Fee Schedule - CPT Code |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $179.69since 2025-10-01 | — | — | Plans must pay at least this | — | SoonerCare Title XIX Fee Schedule |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $176.77since 2025-10-01 | unit | — | Paid by the state, outside plans | — | IHCP Professional Fee Schedule (Last Upd |
| ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $172.73since 2026-08-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Physicia |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $170.58since 2025-10-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $165.82since 2026-07-01 | — | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $165.66since 2026-02-01 | — | — | Plans must pay at least this | — | Physician Administered Drug (PAD) Pricin |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $161.54since 2025-04-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service CPT |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $161.54since 2025-05-16 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $161.54since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Preventive fee schedule (202 |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $153.54since 2026-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $148.20since 2023-10-01 | — | — | Plans expected to pay at least this | — | ODM Outpatient Hospital Behavioral Healt |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $148.20since 2023-10-03 | — | — | Not classified | — | CMAP fee schedule: Clinic - Dialysis 4/1 |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $145.95since 2024-09-03 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Local Health D |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $141.70since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $40.00since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $40.00since 2023-10-03 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $38.61since 2023-10-03 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid ad hoc fee schedule: C |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $21.96since 2024-10-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP) | $15.00since 2025-01-01 | — | — | Not classified | — | DMAP 2025 Physician Fee Schedule |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas ARKids First-B (CHIP) | $13.14since 2025-10-08 | — | — | Not classified | — | Arkansas Medicaid ARKids First-B Screeni |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $2.67since 2025-01-01 | — | — | Plans must pay at least this | — | HCA Enhanced pediatric fee schedule (enh |
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 91304?
It depends on the state. Of the 38 states with a published fee-for-service rate, the median is $174.75. Utah pays the most ($232.22) and Washington the least ($2.67).
Which state pays the highest Medicaid rate for 91304?
Utah, at $232.22, effective 2026-10-01.
Do managed-care plans pay the same rate for 91304?
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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Track 91304 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.