97034 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 34 state Medicaid programs publish a fee-for-service rate for 97034 at the physician psychologist level. Rates run from $4.97 in Kentucky to $27.00 in Texas, with a median of $11.66.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 34
- Median rate
- $11.66units vary by state
- Highest
- $27.00Texas
- Medicare (non-facility)
- $13.01–$17.602026 physician fee schedule
97034 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 |
|---|---|---|---|---|---|---|
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $27.00since 2019-09-01 | 15 min | $108.00 | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $24.71since 2021-01-01 | 15 min | $98.84 | Plans negotiate; applies out of network | 173% | 2026 Fee Schedule - Covered Procedures R |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $21.93since 2026-07-01 | 15 min | $87.72 | Plans negotiate; applies out of network | 165% | Nebraska Medicaid fee schedule 471-000-5 |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $19.81since 2025-01-01 | 15 min | $79.24 | Plans must pay at least this | 146% | New Mexico Medicaid Fee for Service CPT |
| MontanaPhysician or licensed psychologist (incl. BCBA-D) · Montana Medicaid and HMK Plus (fee-for-service) | $19.72since 2026-07-01 | 15 min | $78.88 | Not classified | 141% | Montana Healthcare Programs fee schedule |
| NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $15.59since 2020-03-01 | 15 min | $62.36 | Paid by the state, outside plans | — | Provider Type 60 School Based (rate data |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $14.71since 2026-01-01 | 15 min | $58.84 | Not classified | 100–104% | Maryland Medicaid Professional Services |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $14.52since 2026-10-01 | 15 min | $58.08 | Plans negotiate; applies out of network | 105% | 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) | $13.38since 2013-07-01 | 15 min | $53.52 | Plans must pay at least this | 101% | Iowa Medicaid fee schedule #02 PHYSICIAN |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $12.98since 1995-01-02 | 15 min | $51.92 | Plans negotiate; applies out of network | 90–96% | PA DHS PROMISe Outpatient Fee Schedule ( |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $12.91since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $12.88since 2026-07-01 | 15 min | $51.52 | Plans negotiate; applies out of network | 95% | Utah Medicaid Coverage and Reimbursement |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $12.33since 2024-08-01 | 15 min | $49.32 | Paid by the state, outside plans | 93% | KMAP Fee Schedule MKN Medicaid (FeeSched |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $12.15since 2026-07-01 | 15 min | $48.60 | Plans negotiate; applies out of network | 88% | DMAS procedure fee file cptmedical4.csv |
| North CarolinaPhysician or licensed psychologist (incl. BCBA-D) · North Carolina Medicaid Direct (fee-for-service) | $11.85since 2025-10-01 | 15 min | $47.40 | Plans must pay at least this | 88% | NC Medicaid fee schedule 'Physician Serv |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $11.74since 2026-01-01 | 15 min | $46.96 | Not classified | 85% | Vermont Medicaid Fee Schedule - CPT Code |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $11.71since 2026-07-01 | 15 min | $46.84 | Plans must pay at least this | 90% | DOM Comprehensive Fee Schedule, Septembe |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $11.60since 2026-07-01 | 15 min | $46.40 | Plans negotiate; applies out of network | 80% | Child Health Plan Plus FY 2026-2027 Fee |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $11.51since 2026-07-01 | 15 min | $46.04 | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $11.48since 2026-01-01 | 15 min | $45.92 | Not classified | 78% | CMAP fee schedule: Independent Physical |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $11.00since 2022-07-01 | 15 min | $44.00 | Plans must pay at least this | 80–84% | MO HealthNet fee schedule: Podiatry |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $10.97since 2026-10-01 | 15 min | $43.88 | Plans negotiate; applies out of network | 70–76% | Emergency Adoption (date filed: Septembe |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $10.54since 2026-02-01 | 15 min | $42.16 | Plans negotiate; applies out of network | 75% | MHCP Fee Schedule - Current Fee Schedule |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $10.47since 2008-07-01 | 15 min | $41.88 | Plans negotiate; applies out of network | 77% | ForwardHealth max fee schedule: Therapy- |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $10.20since 2024-01-01 | 15 min | $40.80 | Plans negotiate; applies out of network | 76% | Appendix DD to OAC 5160-1-60 (Non-Instit |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $9.68since 2026-01-01 | 15 min | $38.72 | Not classified | 70–72% | MaineCare Fee Schedule (MaineCare UCR, H |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $9.52since 2026-04-01 | 15 min | $38.08 | Plans negotiate; applies out of network | 72% | BMS RBRVS 2026 Effective 4/1/26 - 3/31/2 |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $9.08since 2017-01-01 | 15 min | $36.32 | Plans negotiate; applies out of network | 64–68% | OutPatient Max Allowed Site of Service F |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $9.06since 2024-04-01 | 15 min | $36.24 | Plans negotiate; applies out of network | 62–66% | HFS Practitioner Fee Schedule (effective |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $8.95since 2024-01-01 | 15 min | $35.80 | Plans negotiate; applies out of network | 64–66% | MDHHS Occupational Therapy Fee Schedule |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $8.41since 2026-07-01 | 15 min | $33.64 | Plans negotiate; applies out of network | 53–58% | HCA Habilitative services fee schedule ( |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $8.08since 2025-01-01 | 15 min | $32.32 | Not classified | 52–54% | NJMMIS Procedure Master Listing CPTHCPCS |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $7.83since 2026-10-01 | 15 min | $31.32 | Plans negotiate; applies out of network | 44–54% | Medi-Cal Rates (Rates files zip: rates_d |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $4.97since 2026-01-01 | 15 min | $19.88 | Plans negotiate; applies out of network | 37% | KY Medicaid OT fee schedule (2026Occupat |
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 97034?
It depends on the state. Of the 34 states with a published fee-for-service rate, the median is $11.66. Texas pays the most ($27.00 per 15 min) and Kentucky the least ($4.97 per 15 min).
Which state pays the highest Medicaid rate for 97034?
Texas, at $27.00 per 15 min ($108.00 per hour), effective 2019-09-01.
How do Medicaid rates for 97034 compare with Medicare?
Where the billing units match, Medicaid pays between 37% and 173% of the 2026 Medicare physician fee schedule amount for the state (non-facility).
Do managed-care plans pay the same rate for 97034?
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.
Related Physician & professional codes
10005Physician and practitioner services (fee schedule) · 42 states10006Physician and practitioner services (fee schedule) · 42 states10007Physician and practitioner services (fee schedule) · 42 states10008Physician and practitioner services (fee schedule) · 42 states10009Physician and practitioner services (fee schedule) · 42 states10010Physician and practitioner services (fee schedule) · 42 states10021Physician and practitioner services (fee schedule) · 42 states10030Physician and practitioner services (fee schedule) · 42 states10060Physician and practitioner services (fee schedule) · 42 states10061Physician and practitioner services (fee schedule) · 42 states10080Physician and practitioner services (fee schedule) · 42 states10081Physician and practitioner services (fee schedule) · 42 states
Track 97034 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.