96133 Medicaid reimbursement rates by state
Mental health assessment (non-physician). 24 state Medicaid programs publish a fee-for-service rate for 96133 at the physician psychologist level. Rates run from $34.94 in New Jersey to $825.87 in California, with a median of $71.77.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 24
- Median rate
- $71.77units vary by state
- Highest
- $825.87California
- Medicare (non-facility)
- $93.47–$118.782026 physician fee schedule
96133 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) | $825.87⚠ over 3× mediansince 2026-07-01 | hour | $825.87 | Paid by the state, outside plans | — | Medi-Cal Behavioral Health Fee Schedules |
| NebraskaPhysician or licensed psychologist (incl. BCBA-D) · Nebraska Medicaid (fee-for-service) | $135.38since 2026-07-01 | hour | $135.38 | Plans negotiate; applies out of network | — | Nebraska Medicaid Mental Health and Subs |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $113.97since 2022-01-01 | hour | $113.97 | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| MassachusettsPhysician or licensed psychologist (incl. BCBA-D) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $110.58since 2025-09-01 | hour | $110.58 | Plans must pay at least this | — | Rates for Mental Health Services Provide |
| MissouriPhysician or licensed psychologist (incl. BCBA-D) · Missouri MO HealthNet (fee-for-service) | $101.70since 2022-07-01 | hour | $101.70 | Plans must pay at least this | — | MO HealthNet fee schedule: Behavioral He |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $100.53since 2026-07-01 | hour | $100.53 | Plans negotiate; applies out of network | — | Child Health Plan Plus Behavioral Health |
| OhioAgency provider · Ohio Medicaid (fee-for-service) | $88.29since 2024-01-01 | Additional 60 Minutes | — | Plans expected to pay at least this | — | OAC 5160-27-03 Appendix A, Community Beh |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $86.22since 2026-01-01 | hour | $86.22 | Not classified | — | Maryland Medicaid Professional Services |
| New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service) | $83.43since 2026-01-01 | hour | $83.43 | Plans negotiate; applies out of network | — | eMedNY Clinical Psychology Procedure Cod |
| MinnesotaPhysician or licensed psychologist (incl. BCBA-D) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $81.51since 2026-05-21 | hour | $81.51 | Plans must pay at least this | — | MH Procedure CPT or HCPC Codes and Rates |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $72.91since 2026-10-01 | hour | $72.91 | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $72.05since 2026-07-01 | hour | $72.05 | Plans negotiate; applies out of network | — | DMAS procedure fee file cptmedical4.csv |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $71.48since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $71.24since 2019-01-01 | hour | $71.24 | Plans negotiate; applies out of network | — | Max Allow Payment_OutP Site of Service ( |
| North CarolinaPhysician or licensed psychologist (incl. BCBA-D) · North Carolina Medicaid Direct (fee-for-service) | $70.91since 2025-10-01 | hour | $70.91 | Plans must pay at least this | — | NC Medicaid fee schedule 'Physician Serv |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $66.69since 2021-09-30 | hour | $66.69 | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| LouisianaPhysician or licensed psychologist (incl. BCBA-D) · Louisiana Medicaid (fee-for-service) | $63.62since 2025-07-01 | hour | $63.62 | Plans must pay at least this | — | Specialized Behavioral Health Services f |
| KentuckyPhysician or licensed psychologist (incl. BCBA-D) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $62.53since 2023-07-01 | 30 min | $125.06 | 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) | $62.41since 2026-01-01 | hour | $62.41 | Plans negotiate; applies out of network | — | MDHHS Child and Adolescent Health Center |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $58.67since 2026-07-01 | hour | $58.67 | Plans negotiate; applies out of network | — | HCA Mental health and psychology service |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $57.94since 2025-09-01 | hour | $57.94 | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $54.81since 2026-01-01 | hour | $54.81 | Plans negotiate; applies out of network | — | Practitioner Fee Schedule (2026-01-01) |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $38.81since 2024-04-01 | hour | $38.81 | Plans negotiate; applies out of network | — | HFS LPHA Fee Schedule (effective 2024-04 |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $34.94since 2026-07-01 | hour | $34.94 | 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 96133?
It depends on the state. Of the 24 states with a published fee-for-service rate, the median is $71.77. California pays the most ($825.87 per hour) and New Jersey the least ($34.94 per hour).
Which state pays the highest Medicaid rate for 96133?
California, at $825.87 per hour ($825.87 per hour), effective 2026-07-01.
Do managed-care plans pay the same rate for 96133?
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) · 25 states90832Outpatient psychotherapy and diagnostic evaluation · 25 states90834Outpatient psychotherapy and diagnostic evaluation · 25 states90837Outpatient psychotherapy and diagnostic evaluation · 25 states90847Outpatient psychotherapy and diagnostic evaluation · 25 states90853Outpatient psychotherapy and diagnostic evaluation · 25 states96110Mental health assessment (non-physician) · 25 states96112Mental health assessment (non-physician) · 25 states96130Mental health assessment (non-physician) · 25 states96131Mental health assessment (non-physician) · 25 states96136Mental health assessment (non-physician) · 25 states96137Mental health assessment (non-physician) · 25 states
Track 96133 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.