96381 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 26 state Medicaid programs publish a fee-for-service rate for 96381 at the physician psychologist level. Rates run from $10.00 in Florida to $27.21 in New Mexico, with a median of $15.76.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 26
- Median rate
- $15.76units vary by state
- Highest
- $27.21New Mexico
- Medicare (non-facility)
- $21.74–$28.782026 physician fee schedule
96381 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) | $27.21since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service CPT |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $23.03since 2024-10-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Child and Adolescent Health Center |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $21.12since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file cptmedical4.csv |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $20.92since 2026-07-01 | — | — | Plans must pay at least this | — | SoonerCare Title XIX Fee Schedule |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $20.75since 2026-07-01 | — | — | Not classified | — | Immunization Rates (07/26) |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $20.49since 2026-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $20.26since 2023-10-06 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN VFC Rate (FeeSched |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $20.22since 2026-08-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Physicia |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $19.15since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $17.85since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $17.53since 2024-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $16.14since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | Schedule of Maximum Allw Pymt Physician |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $15.98since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Physician fee schedule (2024 |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $15.53since 2024-01-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, Septembe |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $15.34since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $15.31since 2025-07-01 | — | — | Plans must pay at least this | — | Louisiana Medicaid Immunization Fee Sche |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $15.31since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Emergency Adoption (date filed: Septembe |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $15.10since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Physician-related services fee sched |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $15.00since 2023-10-06 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $15.00since 2023-10-06 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $14.80since 2025-10-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Clinical Pharm |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $14.51since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | ODM provider-administered pharmaceutical |
| NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $13.28since 2023-10-06 | — | — | Plans must pay at least this | — | Provider Type 32, Specialty 249 Communit |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $12.51since 2026-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $11.29since 2024-10-01 | — | — | Plans negotiate; applies out of network | — | SCDHHS Nurse Midwives Fee Schedule (sche |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $10.00since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Prescribed Drugs Immunization Fee Schedu |
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 96381?
It depends on the state. Of the 26 states with a published fee-for-service rate, the median is $15.76. New Mexico pays the most ($27.21) and Florida the least ($10.00).
Which state pays the highest Medicaid rate for 96381?
New Mexico, at $27.21, effective 2025-01-01.
Do managed-care plans pay the same rate for 96381?
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 96381 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.