96165 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 23 state Medicaid programs publish a fee-for-service rate for 96165 at the physician psychologist level. Rates run from $0.99 in Kansas to $4.74 in Iowa, with a median of $3.80.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 23
- Median rate
- $3.80units vary by state
- Highest
- $4.74Iowa
- Medicare (non-facility)
- $4.83–$6.002026 physician fee schedule
96165 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 |
|---|---|---|---|---|---|---|
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $4.74since 2024-01-01 | 15 min | $18.96 | Plans must pay at least this | 97% | Iowa Medicaid fee schedule #29 PSYCHOLOG |
| MissouriPhysician or licensed psychologist (incl. BCBA-D) · Missouri MO HealthNet (fee-for-service) | $4.47since 2022-07-01 | 15 min | $17.88 | 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) | $4.44since 2022-01-01 | 15 min | $17.76 | Plans negotiate; applies out of network | 90% | 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) | $4.17since 2026-10-01 | 15 min | $16.68 | Plans negotiate; applies out of network | 84% | AHCCCS Arizona Health Care Cost Containm |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $4.15since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid School Program (school-based services) | $4.15since 2020-01-01 | 15 min | $16.60 | Paid by the state, outside plans | 85% | ODM CPT/HCPCS procedure code changes for |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $4.14since 2026-07-01 | 15 min | $16.56 | Plans must pay at least this | 75–81% | HCA Physician-related services fee sched |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $4.08since 2026-01-01 | 15 min | $16.32 | Plans negotiate; applies out of network | 78–82% | OHP FFS behavioral health fee schedule ( |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $4.01since 2026-10-01 | 15 min | $16.04 | Plans negotiate; applies out of network | 67–77% | 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) | $3.88since 2026-07-01 | 15 min | $15.52 | Paid by the state, outside plans | 75% | Integrated Care Fee Schedule FY26-27 |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $3.85since 2026-02-01 | 15 min | $15.40 | Plans negotiate; applies out of network | 76% | MHCP Fee Schedule - Current Fee Schedule |
| OklahomaPhysician or licensed psychologist (incl. BCBA-D) · Oklahoma SoonerCare (fee-for-service, OHCA) | $3.80since 2022-07-01 | 15 min | $15.20 | Plans must pay at least this | 78% | ODMHSAS PICIS 'SoonerCare - Psychologist |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $3.70since 2020-01-01 | 15 min | $14.80 | Plans negotiate; applies out of network | 76% | KY Medicaid Physician fee schedule (2020 |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $3.47since 2026-07-01 | 15 min | $13.88 | Plans negotiate; applies out of network | 70% | DMAS procedure fee file cptmedical4.csv |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $3.36since 2020-01-01 | 15 min | $13.44 | Plans negotiate; applies out of network | 67–69% | OutPatient Site of Service (in Zipped Fe |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $3.09since 2020-01-01 | 15 min | $12.36 | Plans negotiate; applies out of network | 61–63% | TMHP Texas Medicaid Fee Schedule - Physi |
| LouisianaPhysician or licensed psychologist (incl. BCBA-D) · Louisiana Medicaid (fee-for-service) | $3.06since 2025-07-01 | 15 min | $12.24 | Plans must pay at least this | — | Specialized Behavioral Health Services f |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $2.98since 2026-10-01 | 15 min | $11.92 | Plans negotiate; applies out of network | 55–58% | Emergency Adoption (date filed: Septembe |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $2.98since 2026-01-01 | 15 min | $11.92 | Not classified | 57% | CMAP fee schedule: Physician Office and |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $2.88since 2025-01-01 | 15 min | $11.52 | Plans negotiate; applies out of network | 58–59% | MDHHS Non-Physician Behavioral Health Fe |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $2.54since 2024-07-01 | 15 min | $10.16 | Plans negotiate; applies out of network | 52% | SCDHHS Nurse Midwives Fee Schedule (sche |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $2.51since 2026-07-01 | 15 min | $10.04 | Not classified | 46–48% | NJMMIS Procedure Master Listing CPTHCPCS |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $0.99since 2020-01-01 | 15 min | $3.96 | 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 96165?
It depends on the state. Of the 23 states with a published fee-for-service rate, the median is $3.80. Iowa pays the most ($4.74 per 15 min) and Kansas the least ($0.99 per 15 min).
Which state pays the highest Medicaid rate for 96165?
Iowa, at $4.74 per 15 min ($18.96 per hour), effective 2024-01-01.
How do Medicaid rates for 96165 compare with Medicare?
Where the billing units match, Medicaid pays between 20% and 97% of the 2026 Medicare physician fee schedule amount for the state (non-facility).
Do managed-care plans pay the same rate for 96165?
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 96165 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.