96168 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 26 state Medicaid programs publish a fee-for-service rate for 96168 at the physician psychologist level. Rates run from $5.72 in Kansas to $36.64 in New Mexico, with a median of $20.15.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 26
- Median rate
- $20.15units vary by state
- Highest
- $36.64New Mexico
- Medicare (non-facility)
- $27.41–$33.652026 physician fee schedule
96168 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) | $36.64since 2025-01-01 | 15 min | $146.56 | Plans must pay at least this | 131% | New Mexico Medicaid Fee for Service CPT |
| MissouriPhysician or licensed psychologist (incl. BCBA-D) · Missouri MO HealthNet (fee-for-service) | $25.05since 2022-07-01 | 15 min | $100.20 | 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) | $24.16since 2022-01-01 | 15 min | $96.64 | Plans negotiate; applies out of network | 87% | 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) | $23.61since 2026-10-01 | 15 min | $94.44 | 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) | $23.02since 2026-01-01 | 15 min | $92.08 | Plans negotiate; applies out of network | 78–81% | OHP FFS behavioral health fee schedule ( |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $22.77since 2026-07-01 | 15 min | $91.08 | Plans must pay at least this | 74–79% | HCA Physician-related services fee sched |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $22.11since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $22.06since 2020-01-01 | 15 min | $88.24 | Plans must pay at least this | 78% | Provider Type 26 Psychologist Reimbursem |
| 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) | $21.95since 2026-10-01 | 15 min | $87.80 | State-directed payment | 65–75% | Medi-Cal Rates (Rates files zip: rates_d |
| PennsylvaniaPhysician or licensed psychologist (incl. BCBA-D) · Pennsylvania Medical Assistance (fee-for-service) | $21.77since 2024-09-09 | 15 min | $87.08 | 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) | $21.61since 2026-02-01 | 15 min | $86.44 | Plans negotiate; applies out of network | 76% | MHCP Fee Schedule - Current Fee Schedule |
| ColoradoAny qualified provider (rate does not vary by provider) · Colorado behavioral health services paid fee-for-service by HCPF (outside the RAE capitation) | $20.56since 2026-07-01 | 15 min | $82.24 | Paid by the state, outside plans | 71% | Integrated Care Fee Schedule FY26-27 |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $20.45since 2020-01-01 | 15 min | $81.80 | Plans negotiate; applies out of network | 74% | KY Medicaid Physician fee schedule (2020 |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $19.85since 2020-01-01 | 15 min | $79.40 | Plans negotiate; applies out of network | 69–72% | OutPatient Site of Service (in Zipped Fe |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $19.68since 2026-07-01 | 15 min | $78.72 | Plans negotiate; applies out of network | 70% | DMAS procedure fee file cptmedical4.csv |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $19.65since 2025-09-01 | 15 min | $78.60 | Plans negotiate; applies out of network | 68–71% | TMHP Texas Medicaid Fee Schedule - Physi |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $18.11since 2026-01-01 | 15 min | $72.44 | Plans negotiate; applies out of network | 64–65% | MDHHS Certified Nurse Midwife Fee Schedu |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $18.08since 2024-01-01 | 15 min | $72.32 | Plans must pay at least this | 66% | Iowa Medicaid fee schedule #29 PSYCHOLOG |
| LouisianaPhysician or licensed psychologist (incl. BCBA-D) · Louisiana Medicaid (fee-for-service) | $16.74since 2025-07-01 | 15 min | $66.96 | Plans must pay at least this | — | Specialized Behavioral Health Services f |
| OklahomaPhysician or licensed psychologist (incl. BCBA-D) · Oklahoma SoonerCare (fee-for-service, OHCA) | $15.79since 2022-07-01 | 15 min | $63.16 | Plans must pay at least this | 57% | ODMHSAS PICIS 'SoonerCare - Psychologist |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $15.54since 2026-10-01 | 15 min | $62.16 | Plans negotiate; applies out of network | 51–54% | Emergency Adoption (date filed: Septembe |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $15.39since 2025-01-01 | 15 min | $61.56 | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid School Program (school-based services) | $15.34since 2020-01-01 | 15 min | $61.36 | Paid by the state, outside plans | 55% | ODM CPT/HCPCS procedure code changes for |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $13.83since 2024-07-01 | 15 min | $55.32 | Plans negotiate; applies out of network | 50% | SCDHHS Nurse Midwives Fee Schedule (sche |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $11.98since 2026-01-01 | 15 min | $47.92 | Not classified | 41% | CMAP fee schedule: Physician Office and |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $5.72since 2020-01-01 | 15 min | $22.88 | 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 96168?
It depends on the state. Of the 26 states with a published fee-for-service rate, the median is $20.15. New Mexico pays the most ($36.64 per 15 min) and Kansas the least ($5.72 per 15 min).
Which state pays the highest Medicaid rate for 96168?
New Mexico, at $36.64 per 15 min ($146.56 per hour), effective 2025-01-01.
How do Medicaid rates for 96168 compare with Medicare?
Where the billing units match, Medicaid pays between 21% and 131% of the 2026 Medicare physician fee schedule amount for the state (non-facility).
Do managed-care plans pay the same rate for 96168?
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 96168 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.