96167 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 26 state Medicaid programs publish a fee-for-service rate for 96167 at the physician psychologist level. Rates run from $16.08 in Kansas to $102.39 in New Mexico, with a median of $56.63.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 26
- Median rate
- $56.63units vary by state
- Highest
- $102.39New Mexico
- Medicare (non-facility)
- $75.57–$92.772026 physician fee schedule
96167 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) | $102.39since 2025-01-01 | 30 min | $204.78 | Plans must pay at least this | 134% | New Mexico Medicaid Fee for Service CPT |
| MissouriPhysician or licensed psychologist (incl. BCBA-D) · Missouri MO HealthNet (fee-for-service) | $70.65since 2022-07-01 | 30 min | $141.30 | 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) | $68.05since 2022-01-01 | 30 min | $136.10 | 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) | $65.62since 2026-10-01 | 30 min | $131.24 | Plans negotiate; applies out of network | 85% | AHCCCS Arizona Health Care Cost Containm |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $63.50since 2026-01-01 | 30 min | $127.00 | Plans negotiate; applies out of network | 78–81% | OHP FFS behavioral health fee schedule ( |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $62.23since 2020-01-01 | 30 min | $124.46 | Plans must pay at least this | 80% | Provider Type 26 Psychologist Reimbursem |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $62.16since 2024-01-01 | 30 min | $124.32 | Plans negotiate; applies out of network | — | HCA Substance use disorder fee schedule |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $61.88since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $61.83since 2026-10-01 | 30 min | $123.66 | Plans negotiate; applies out of network | 67–77% | Medi-Cal Rates (Rates files zip: rates_d |
| PennsylvaniaPhysician or licensed psychologist (incl. BCBA-D) · Pennsylvania Medical Assistance (fee-for-service) | $61.33since 2024-09-09 | 30 min | $122.66 | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $60.20since 2026-02-01 | 30 min | $120.40 | Plans negotiate; applies out of network | 77% | MHCP Fee Schedule - Current Fee Schedule |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $57.65since 2020-01-01 | 30 min | $115.30 | 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) | $57.38since 2026-07-01 | 30 min | $114.76 | Paid by the state, outside plans | 72% | Integrated Care Fee Schedule FY26-27 |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $55.88since 2020-01-01 | 30 min | $111.76 | Plans negotiate; applies out of network | 71–73% | OutPatient Site of Service (in Zipped Fe |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $54.73since 2025-09-01 | 30 min | $109.46 | Plans negotiate; applies out of network | 69–72% | TMHP Texas Medicaid Fee Schedule - Physi |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $54.69since 2026-07-01 | 30 min | $109.38 | Plans negotiate; applies out of network | 70% | DMAS procedure fee file cptmedical4.csv |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $49.84since 2026-01-01 | 30 min | $99.68 | Plans negotiate; applies out of network | 64–65% | MDHHS Certified Nurse Midwife Fee Schedu |
| LouisianaPhysician or licensed psychologist (incl. BCBA-D) · Louisiana Medicaid (fee-for-service) | $46.73since 2025-07-01 | 30 min | $93.46 | 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) | $44.11since 2026-10-01 | 30 min | $88.22 | 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) | $38.55since 2024-07-01 | 30 min | $77.10 | Plans negotiate; applies out of network | 50% | SCDHHS Nurse Midwives Fee Schedule (sche |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $36.16since 2024-01-01 | 30 min | $72.32 | Plans must pay at least this | 47% | Iowa Medicaid fee schedule #29 PSYCHOLOG |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $35.00since 2025-01-01 | 30 min | $70.00 | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| OklahomaPhysician or licensed psychologist (incl. BCBA-D) · Oklahoma SoonerCare (fee-for-service, OHCA) | $31.58since 2022-07-01 | 30 min | $63.16 | Plans must pay at least this | 42% | ODMHSAS PICIS 'SoonerCare - Psychologist |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $23.98since 2026-01-01 | 30 min | $47.96 | Not classified | 30% | CMAP fee schedule: Physician Office and |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid School Program (school-based services) | $19.17since 2020-01-01 | 30 min | $38.34 | Paid by the state, outside plans | 25% | 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 | $16.08since 2020-01-01 | 30 min | $32.16 | Not classified | 21% | 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 96167?
It depends on the state. Of the 26 states with a published fee-for-service rate, the median is $56.63. New Mexico pays the most ($102.39 per 30 min) and Kansas the least ($16.08 per 30 min).
Which state pays the highest Medicaid rate for 96167?
New Mexico, at $102.39 per 30 min ($204.78 per hour), effective 2025-01-01.
How do Medicaid rates for 96167 compare with Medicare?
Where the billing units match, Medicaid pays between 21% and 134% of the 2026 Medicare physician fee schedule amount for the state (non-facility).
Do managed-care plans pay the same rate for 96167?
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 96167 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.