96164 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 25 state Medicaid programs publish a fee-for-service rate for 96164 at the physician psychologist level. Rates run from $2.19 in Kansas to $14.95 in New Mexico, with a median of $8.10.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 25
- Median rate
- $8.10units vary by state
- Highest
- $14.95New Mexico
- Medicare (non-facility)
- $11.20–$13.892026 physician fee schedule
96164 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 |
|---|---|---|---|---|---|---|
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $14.95since 2025-01-01 | 30 min | $29.90 | Plans must pay at least this | 130% | New Mexico Medicaid Fee for Service CPT |
| MissouriPhysician or licensed psychologist (incl. BCBA-D) · Missouri MO HealthNet (fee-for-service) | $9.94since 2022-07-01 | 30 min | $19.88 | Plans must pay at least this | — | MO HealthNet fee schedule: Behavioral He |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $9.72since 2026-10-01 | 30 min | $19.44 | Plans negotiate; applies out of network | 84% | AHCCCS Arizona Health Care Cost Containm |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $9.48since 2024-01-01 | 30 min | $18.96 | Plans must pay at least this | 85% | Iowa Medicaid fee schedule #29 PSYCHOLOG |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $9.43since 2026-01-01 | 30 min | $18.86 | Plans negotiate; applies out of network | 78–81% | OHP FFS behavioral health fee schedule ( |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $9.35since 2022-01-01 | 30 min | $18.70 | Plans negotiate; applies out of network | 83% | ForwardHealth max fee schedule: Mntl Hlt |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $9.31since 2026-07-01 | 30 min | $18.62 | Plans must pay at least this | 73–78% | HCA Physician-related services fee sched |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $9.09since 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) | $8.74since 2026-02-01 | 30 min | $17.48 | Plans negotiate; applies out of network | 76% | MHCP Fee Schedule - Current Fee Schedule |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $8.59since 2020-01-01 | 30 min | $17.18 | Plans must pay at least this | 74% | Provider Type 26 Psychologist Reimbursem |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $8.52since 2026-10-01 | 30 min | $17.04 | Plans negotiate; applies out of network | 61–71% | Medi-Cal Rates (Rates files zip: rates_d |
| ColoradoAny qualified provider (rate does not vary by provider) · Colorado behavioral health services paid fee-for-service by HCPF (outside the RAE capitation) | $8.22since 2026-07-01 | 30 min | $16.44 | Paid by the state, outside plans | 69% | Integrated Care Fee Schedule FY26-27 |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $8.10since 2026-07-01 | 30 min | $16.20 | Plans negotiate; applies out of network | 70% | DMAS procedure fee file cptmedical4.csv |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $7.94since 2020-01-01 | 30 min | $15.88 | Plans negotiate; applies out of network | 70% | KY Medicaid Physician fee schedule (2020 |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $7.63since 2020-01-01 | 30 min | $15.26 | Plans negotiate; applies out of network | 64–67% | OutPatient Site of Service (in Zipped Fe |
| OklahomaPhysician or licensed psychologist (incl. BCBA-D) · Oklahoma SoonerCare (fee-for-service, OHCA) | $7.60since 2022-07-01 | 30 min | $15.20 | Plans must pay at least this | 67% | ODMHSAS PICIS 'SoonerCare - Psychologist |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $7.02since 2020-01-01 | 30 min | $14.04 | Plans negotiate; applies out of network | 59–62% | TMHP Texas Medicaid Fee Schedule - Physi |
| LouisianaPhysician or licensed psychologist (incl. BCBA-D) · Louisiana Medicaid (fee-for-service) | $6.80since 2025-07-01 | 30 min | $13.60 | 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) | $6.71since 2026-01-01 | 30 min | $13.42 | Plans negotiate; applies out of network | 57–59% | MDHHS Non-Physician Behavioral Health Fe |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $6.41since 2026-10-01 | 30 min | $12.82 | Plans negotiate; applies out of network | 51–54% | Emergency Adoption (date filed: Septembe |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $5.97since 2026-01-01 | 30 min | $11.94 | Not classified | 49% | CMAP fee schedule: Physician Office and |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $5.87since 2026-07-01 | 30 min | $11.74 | Not classified | 46–48% | NJMMIS Procedure Master Listing CPTHCPCS |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $5.60since 2024-07-01 | 30 min | $11.20 | Plans negotiate; applies out of network | — | SCDHHS Nurse Midwives Fee Schedule (sche |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid School Program (school-based services) | $5.19since 2020-01-01 | 30 min | $10.38 | Paid by the state, outside plans | 46% | ODM CPT/HCPCS procedure code changes for |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $2.19since 2020-01-01 | 30 min | $4.38 | Not classified | 20% | KMAP Fee Schedule QMB Medicaid (FeeSched |
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 96164?
It depends on the state. Of the 25 states with a published fee-for-service rate, the median is $8.10. New Mexico pays the most ($14.95 per 30 min) and Kansas the least ($2.19 per 30 min).
Which state pays the highest Medicaid rate for 96164?
New Mexico, at $14.95 per 30 min ($29.90 per hour), effective 2025-01-01.
How do Medicaid rates for 96164 compare with Medicare?
Where the billing units match, Medicaid pays between 20% and 130% of the 2026 Medicare physician fee schedule amount for the state (non-facility).
Do managed-care plans pay the same rate for 96164?
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 96164 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.