96159 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 25 state Medicaid programs publish a fee-for-service rate for 96159 at the physician psychologist level. Rates run from $12.19 in Connecticut to $37.44 in Alabama, with a median of $18.46.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 25
- Median rate
- $18.46units vary by state
- Highest
- $37.44Alabama
- Medicare (non-facility)
- $24.51–$30.282026 physician fee schedule
96159 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 |
|---|---|---|---|---|---|---|
| AlabamaPhysician or licensed psychologist (incl. BCBA-D) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $37.44since 2026-09-24 | 15 min | $149.76 | Not classified | 152% | Teaching Facility Fee Schedule |
| MissouriPhysician or licensed psychologist (incl. BCBA-D) · Missouri MO HealthNet (fee-for-service) | $22.65since 2022-07-01 | 15 min | $90.60 | Plans must pay at least this | — | MO HealthNet fee schedule: Behavioral He |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $22.11since 2022-01-01 | 15 min | $88.44 | Plans negotiate; applies out of network | 88% | ForwardHealth max fee schedule: Mntl Hlt |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $21.18since 2026-10-01 | 15 min | $84.72 | Plans negotiate; applies out of network | 84% | AHCCCS Arizona Health Care Cost Containm |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $20.65since 2026-01-01 | 15 min | $82.60 | Plans negotiate; applies out of network | 78–81% | OHP FFS behavioral health fee schedule ( |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal Targeted Rate Increase fee schedule (fee-for-service; plans pay at least this under the TRI directed payment) | $20.11since 2026-10-01 | 15 min | $80.44 | State-directed payment | 66–76% | Medi-Cal Rates (Rates files zip: rates_d |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $20.04since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $19.55since 2026-02-01 | 15 min | $78.20 | Plans negotiate; applies out of network | 76% | MHCP Fee Schedule - Current Fee Schedule |
| PennsylvaniaPhysician or licensed psychologist (incl. BCBA-D) · Pennsylvania Medical Assistance (fee-for-service) | $19.47since 2024-09-09 | 15 min | $77.88 | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $19.08since 2024-01-01 | 15 min | $76.32 | Plans must pay at least this | 77% | Iowa Medicaid fee schedule #02 PHYSICIAN |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $18.73since 2020-01-01 | 15 min | $74.92 | Plans negotiate; applies out of network | 76% | KY Medicaid Physician fee schedule (2020 |
| ColoradoAny qualified provider (rate does not vary by provider) · Colorado behavioral health services paid fee-for-service by HCPF (outside the RAE capitation) | $18.54since 2026-07-01 | 15 min | $74.16 | Paid by the state, outside plans | 71% | Integrated Care Fee Schedule FY26-27 |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid School Program (school-based services) | $18.46since 2020-01-01 | 15 min | $73.84 | Paid by the state, outside plans | 74% | ODM CPT/HCPCS procedure code changes for |
| MarylandPhysician or licensed psychologist (incl. BCBA-D) · Maryland Public Behavioral Health System (specialty mental health, SUD and ABA, paid fee-for-service through the Carelon ASO) | $18.12since 2025-07-01 | 15 min | $72.48 | Paid by the state, outside plans | 69–71% | FY2026 PBHS Fee Schedule – Individual Pr |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $18.01since 2020-01-01 | 15 min | $72.04 | Plans negotiate; applies out of network | 71–73% | OutPatient Site of Service (in Zipped Fe |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $17.84since 2025-10-01 | 15 min | $71.36 | Plans must pay at least this | 71% | NC Medicaid fee schedule 'Clinical Pharm |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $17.65since 2026-07-01 | 15 min | $70.60 | Plans negotiate; applies out of network | 70% | DMAS procedure fee file cptmedical4.csv |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $17.00since 2025-01-01 | 15 min | $68.00 | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $16.56since 2020-01-01 | 15 min | $66.24 | Plans negotiate; applies out of network | 64–67% | TMHP Texas Medicaid Fee Schedule - Physi |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $16.30since 2026-07-01 | 15 min | $65.20 | Plans must pay at least this | 59–63% | HCA Physician-related services fee sched |
| LouisianaPhysician or licensed psychologist (incl. BCBA-D) · Louisiana Medicaid (fee-for-service) | $14.99since 2025-07-01 | 15 min | $59.96 | Plans must pay at least this | — | Specialized Behavioral Health Services f |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $14.57since 2026-01-01 | 15 min | $58.28 | Plans negotiate; applies out of network | 58–59% | MDHHS Non-Physician Behavioral Health Fe |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $14.32since 2026-10-01 | 15 min | $57.28 | Plans negotiate; applies out of network | 52–55% | Emergency Adoption (date filed: Septembe |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $12.37since 2024-07-01 | 15 min | $49.48 | Plans negotiate; applies out of network | — | SCDHHS Nurse Midwives Fee Schedule (sche |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $12.19since 2026-01-01 | 15 min | $48.76 | Not classified | 46% | CMAP fee schedule: Physician Office and |
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 96159?
It depends on the state. Of the 25 states with a published fee-for-service rate, the median is $18.46. Alabama pays the most ($37.44 per 15 min) and Connecticut the least ($12.19 per 15 min).
Which state pays the highest Medicaid rate for 96159?
Alabama, at $37.44 per 15 min ($149.76 per hour), effective 2026-09-24.
How do Medicaid rates for 96159 compare with Medicare?
Where the billing units match, Medicaid pays between 46% and 152% of the 2026 Medicare physician fee schedule amount for the state (non-facility).
Do managed-care plans pay the same rate for 96159?
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 96159 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.