96113 Medicaid reimbursement rates by state
Mental health assessment (non-physician). 24 state Medicaid programs publish a fee-for-service rate for 96113 at the physician psychologist level. Rates run from $19.32 in Florida to $412.94 in California, with a median of $45.64.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 24
- Median rate
- $45.64units vary by state
- Highest
- $412.94California
- Medicare (non-facility)
- $53.83–$67.142026 physician fee schedule
96113 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) | $412.94⚠ over 3× mediansince 2026-07-01 | — | — | Paid by the state, outside plans | — | Medi-Cal Behavioral Health Fee Schedules |
| MassachusettsPhysician or licensed psychologist (incl. BCBA-D) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $90.36since 2025-09-01 | — | — | Plans must pay at least this | — | Rates for Mental Health Services Provide |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $68.13since 2022-01-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $60.64since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Part II Policies and Procedures for Chil |
| MissouriPhysician or licensed psychologist (incl. BCBA-D) · Missouri MO HealthNet (fee-for-service) | $60.20since 2022-07-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Behavioral He |
| ArizonaPhysician or licensed psychologist (incl. BCBA-D) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $56.94since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $50.78since 2026-01-01 | — | — | Plans must pay at least this | — | Louisiana Medicaid Enhanced Professional |
| New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service) | $49.76since 2025-04-01 | unit | — | Plans negotiate; applies out of network | — | eMedNY Clinical Psychology Procedure Cod |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $49.58since 2025-10-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Nurse Practiti |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $46.86since 2021-09-01 | — | — | 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) | $46.80since 2026-01-01 | 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) | $46.10since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file cptmedical4.csv |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $45.17since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $41.82since 2025-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $41.12since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $40.40since 2024-07-01 | — | — | Not classified | — | SCDHHS Base Physician Fee Schedule (sche |
| KentuckyPhysician or licensed psychologist (incl. BCBA-D) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $37.03since 2023-07-01 | 30 min | $74.06 | Plans negotiate; applies out of network | — | KY Medicaid Behavioral Health fee schedu |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $35.78since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Vision Fee Schedule database, Janu |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $34.22since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| OhioAgency provider · Ohio Medicaid (fee-for-service) | $31.64since 2024-01-01 | Additional 30 Minutes | — | Plans expected to pay at least this | — | OAC 5160-27-03 Appendix A, Community Beh |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $28.82since 2024-04-01 | — | — | Plans negotiate; applies out of network | — | HFS LPHA Fee Schedule (effective 2024-04 |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $26.56since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | HCA EPSDT fee schedule (epsdt-20260701.x |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $23.93since 2026-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $19.32since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Practitioner Fee Schedule (2026-01-01) |
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 96113?
It depends on the state. Of the 24 states with a published fee-for-service rate, the median is $45.64. California pays the most ($412.94) and Florida the least ($19.32).
Which state pays the highest Medicaid rate for 96113?
California, at $412.94, effective 2026-07-01.
Do managed-care plans pay the same rate for 96113?
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
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Track 96113 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.