92542 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 42 state Medicaid programs publish a fee-for-service rate for 92542 at the physician psychologist level. Rates run from $10.42 in New Jersey to $65.80 in Nebraska, with a median of $20.90.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 42
- Median rate
- $20.90units vary by state
- Highest
- $65.80Nebraska
- Medicare (non-facility)
- $26.37–$35.122026 physician fee schedule
92542 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 |
|---|---|---|---|---|---|---|
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $65.80⚠ over 3× mediansince 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| AlabamaPhysician or licensed psychologist (incl. BCBA-D) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $40.93since 2026-09-24 | — | — | Not classified | — | Teaching Facility Fee Schedule |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $36.00since 2024-03-26 | — | — | Not classified | — | Arkansas Medicaid Hearing Services Fee S |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $34.85since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service CPT |
| MontanaPhysician or licensed psychologist (incl. BCBA-D) · Montana Medicaid and HMK Plus (fee-for-service) | $34.27since 2026-07-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $32.83since 2025-10-01 | — | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Independent Di |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $29.74since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $27.54since 2006-06-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $26.42since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | Appendix DD to OAC 5160-1-60 (Non-Instit |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $24.98since 2022-07-01 | — | — | Plans negotiate; applies out of network | — | MO HealthNet fee schedule: Hearing Aid |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $23.14since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $23.04since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $22.89since 2026-01-01 | — | — | Not classified | — | CMAP fee schedule: Physician Office and |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $22.63since 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) | $21.92since 2026-07-01 | — | — | Plans must pay at least this | — | SoonerCare Title XIX Fee Schedule |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $21.90since 2023-07-01 | — | — | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $21.80since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Emergency Adoption (date filed: Septembe |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $21.61since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $21.55since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | HFS Audiology Fee Schedule (effective 20 |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $21.12since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file cptmedical4.csv |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $20.97since 2025-07-01 | — | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $20.82since 2026-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, Septembe |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $20.50since 2026-01-01 | — | — | Not classified | — | Vermont Medicaid Fee Schedule - CPT Code |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $20.34since 2026-07-01 | — | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $19.78since 2025-09-01 | — | — | 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) | $19.66since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $19.58since 2013-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $19.55since 2017-01-01 | — | — | Plans negotiate; applies out of network | — | Physician Maximum Allowed Fee Schedule - |
| New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service) | $18.96since 2025-04-01 | unit | — | Plans negotiate; applies out of network | — | eMedNY Physician Fee Schedule Sect 2 (Me |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $18.23since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Hearing Services Fee Schedule (AHCA Upda |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $18.12since 2008-07-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $17.08since 2026-01-01 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $16.84since 2026-04-01 | — | — | Plans negotiate; applies out of network | — | BMS RBRVS 2026 Effective 4/1/26 - 3/31/2 |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $16.79since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $15.93since 2012-09-12 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| MichiganIndependent (non-agency) provider · Michigan Medicaid (fee-for-service) | $15.55since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Independent Diagnostic Testing Fac |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $14.94since 2026-01-01 | visit | — | Plans negotiate; applies out of network | 55% | KY Medicaid ST fee schedule (2026SpeechT |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $14.71since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Neurodevelopmental centers fee sched |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $13.93since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $13.15since 2024-07-01 | — | — | Plans negotiate; applies out of network | — | SCDHHS Nurse Midwives Fee Schedule (sche |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $11.27since 2015-07-01 | — | — | Plans must pay at least this | — | Provider Type 77 Physician's Assistant R |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $10.42since 2026-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
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 92542?
It depends on the state. Of the 42 states with a published fee-for-service rate, the median is $20.90. Nebraska pays the most ($65.80) and New Jersey the least ($10.42).
Which state pays the highest Medicaid rate for 92542?
Nebraska, at $65.80, effective 2026-07-01.
How do Medicaid rates for 92542 compare with Medicare?
Where the billing units match, Medicaid pays between 55% and 55% of the 2026 Medicare physician fee schedule amount for the state (non-facility).
Do managed-care plans pay the same rate for 92542?
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 92542 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.