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92265 Medicaid reimbursement rates by state

Eye exams and vision services. 34 state Medicaid programs publish a fee-for-service rate for 92265 at the physician psychologist level. Rates run from $22.35 in New Jersey to $91.35 in Arizona, with a median of $35.62.

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

States publishing
34
Median rate
$35.62units vary by state
Highest
$91.35Arizona
Medicare (non-facility)
$79.24–$117.792026 physician fee schedule

92265 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)$91.35since 2026-10-01——Plans negotiate; applies out of network—AHCCCS Arizona Health Care Cost Containm
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$82.26since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$72.88since 2013-01-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$68.69since 2026-02-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$63.55since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
PennsylvaniaPhysician or licensed psychologist (incl. BCBA-D) · Pennsylvania Medical Assistance (fee-for-service)$43.32since 2012-09-08——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$42.24since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$42.16since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$41.10since 2026-01-01——Plans must pay at least this—Louisiana Medicaid Enhanced Professional
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$40.31since 2026-07-01——Plans must pay at least this—SoonerCare Title XIX Fee Schedule
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$39.06since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$39.06since 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)$38.36since 2023-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, May 2026
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$37.71since 2024-07-01——Not classified—SCDHHS Pediatric Subspecialty and Neonat
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$37.61since 2025-03-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$36.46since 2026-02-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$36.04since 2024-01-01——Plans negotiate; applies out of network—Appendix DD to OAC 5160-1-60 (Non-Instit
ArkansasPhysician or licensed psychologist (incl. BCBA-D) · Arkansas Medicaid (fee-for-service)$35.20since 2025-06-13——Not classified—Arkansas Medicaid Physician / CRNA / Fam
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$35.16since 2018-09-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$35.07since 2026-01-01——Plans negotiate; applies out of network—Practitioner Fee Schedule (2026-01-01)
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$34.71since 2026-01-01——Not classified—CMAP fee schedule: Physician Office and
New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service)$34.28since 2023-01-01unit—Plans negotiate; applies out of network—eMedNY Physician Fee Schedule Sect 2 (Me
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$34.21since 2026-01-01——Not classified—Maryland Medicaid Professional Services
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$33.96since 2026-10-01——Plans negotiate; applies out of network—Emergency Adoption (date filed: Septembe
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$33.92since 2022-07-01——Plans must pay at least this—MO HealthNet fee schedule: Radiology - P
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$33.06since 2024-01-01——Plans must pay at least this—Provider Type 20 Physician, MD., Osteopa
North CarolinaPhysician or licensed psychologist (incl. BCBA-D) · North Carolina Medicaid Direct (fee-for-service)$32.26since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Physician Serv
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$32.22since 2017-01-01——Plans negotiate; applies out of network—Physician Maximum Allowed Fee Schedule -
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$29.55since 2024-08-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
MichiganIndependent (non-agency) provider · Michigan Medicaid (fee-for-service)$28.76since 2025-01-01——Plans negotiate; applies out of network—MDHHS Independent Diagnostic Testing Fac
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$27.14since 2026-07-01——Plans negotiate; applies out of network—HCA Physician-related services fee sched
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$25.65since 2020-01-01——Plans negotiate; applies out of network—KY Medicaid Physician fee schedule (2020
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$23.71since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$22.35since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS

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 92265?

It depends on the state. Of the 34 states with a published fee-for-service rate, the median is $35.62. Arizona pays the most ($91.35) and New Jersey the least ($22.35).

Which state pays the highest Medicaid rate for 92265?

Arizona, at $91.35, effective 2026-10-01.

Do managed-care plans pay the same rate for 92265?

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 Vision & hearing codes

92060Eye exams and vision services · 35 states92083Eye exams and vision services · 35 states92235Eye exams and vision services · 35 states92025Eye exams and vision services · 34 states92240Eye exams and vision services · 34 states92242Eye exams and vision services · 34 statesV2624Polishing/resurfacing of ocular prosthesis · 32 statesV2625Enlargement of ocular prosthesis · 31 states92609Therapy using a communication device · 30 statesV2626Reduction of ocular prosthesis · 30 statesV2628Fabrication and fitting of ocular conformer · 30 statesV2627Scleral cover shell · 29 states
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