97537 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 34 state Medicaid programs publish a fee-for-service rate for 97537 at the physician psychologist level. Rates run from $6.50 in Pennsylvania to $3,510.00 in New Jersey, with a median of $25.54.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 34
- Median rate
- $25.54units vary by state
- Highest
- $3,510.00New Jersey
- Medicare (non-facility)
- $29.80–$40.952026 physician fee schedule
97537 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 JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $3,510.00⚠ over 3× mediansince 2025-12-01 | 15 min | $14,040.00 | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| AlaskaAny qualified provider (rate does not vary by provider) · Alaska Medicaid (fee-for-service, Department of Health) | $48.47since 2026-07-01 | 15 min | $193.88 | Not classified | 118% | Alaska Medicaid School-Based Services Fe |
| MontanaPhysician or licensed psychologist (incl. BCBA-D) · Montana Medicaid and HMK Plus (fee-for-service) | $45.07since 2026-07-01 | 15 min | $180.28 | Not classified | 141% | Montana Healthcare Programs fee schedule |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $44.67since 2025-01-01 | 15 min | $178.68 | Plans must pay at least this | 145% | New Mexico Medicaid Fee for Service CPT |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $33.28since 2026-10-01 | 15 min | $133.12 | Plans negotiate; applies out of network | 106% | AHCCCS Arizona Health Care Cost Containm |
| DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP) | $31.28since 2026-01-01 | 15 min | $125.12 | Plans negotiate; applies out of network | 98% | DMAP 2026 Physician Fee Schedule |
| LouisianaPhysician or licensed psychologist (incl. BCBA-D) · Louisiana Residential Options Waiver (ROW, OCDD/OIDD 1915(c) waiver) | $31.25since 2025-11-18 | 15 min | $125.00 | Paid by the state, outside plans | — | Residential Options Waiver rate and proc |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $30.72since 2015-07-01 | 15 min | $122.88 | Plans negotiate; applies out of network | 97% | DMAS procedure fee file cptmedical4.csv |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $30.30since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| District of ColumbiaAny qualified provider (rate does not vary by provider) · DC Medicaid (DHCF) fee-for-service | $28.61since 2026-01-01 | 15 min | $114.44 | Not classified | 80% | REFRP00178CSV - Medical Fee Schedule Rep |
| WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health) | $28.46since 2026-07-01 | 15 min | $113.84 | Not classified | 89% | Wyoming Medicaid Downloadable Fee Schedu |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $27.34since 2026-10-01 | 15 min | $109.36 | Plans negotiate; applies out of network | — | Part II Policies and Procedures for Chil |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $27.17since 2026-07-01 | 15 min | $108.68 | Plans negotiate; applies out of network | 82% | Child Health Plan Plus FY 2026-2027 Fee |
| 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 |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $26.74since 2023-07-01 | 15 min | $106.96 | Plans must pay at least this | 90% | DOM Comprehensive Fee Schedule, Septembe |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $26.47since 2026-07-01 | 15 min | $105.88 | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $25.93since 2026-02-01 | 15 min | $103.72 | Plans negotiate; applies out of network | 76–81% | OHP FFS medical-dental fee schedule (fee |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $25.14since 2026-01-01 | 15 min | $100.56 | Not classified | 75–78% | Maryland Medicaid Professional Services |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $24.70since 2026-02-01 | 15 min | $98.80 | Plans negotiate; applies out of network | 77% | MHCP Fee Schedule - Current Fee Schedule |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $24.27since 2026-10-01 | 15 min | $97.08 | Plans negotiate; applies out of network | 68–73% | Emergency Adoption (date filed: Septembe |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $23.06since 2013-07-01 | 15 min | $92.24 | Plans must pay at least this | 76% | Iowa Medicaid fee schedule #02 PHYSICIAN |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $22.20since 2024-08-01 | 15 min | $88.80 | Paid by the state, outside plans | 73% | KMAP Fee Schedule MKN Medicaid (FeeSched |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid School Program (school-based services) | $20.83since 2020-06-12 | 15 min | $83.32 | Paid by the state, outside plans | 68% | Appendix DD to OAC 5160-1-60 (Non-Instit |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $20.69since 2011-07-11 | 15 min | $82.76 | Not classified | 67% | SCDHHS Base Physician Fee Schedule (sche |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $20.37since 2024-04-01 | 15 min | $81.48 | Plans negotiate; applies out of network | 62–66% | HFS Practitioner Fee Schedule (effective |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $19.49since 2026-07-01 | 15 min | $77.96 | Plans negotiate; applies out of network | 54–59% | HCA Habilitative services fee schedule ( |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $19.31since 2026-01-01 | 15 min | $77.24 | Plans negotiate; applies out of network | 64% | KY Medicaid OT fee schedule (2026Occupat |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $16.52since 2025-07-01 | 15 min | $66.08 | Not classified | 52–54% | MaineCare Section 102 Rehabilitative Ser |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $15.96since 2008-07-01 | 15 min | $63.84 | Plans negotiate; applies out of network | 51% | ForwardHealth max fee schedule: Medical- |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $11.51since 2023-07-01 | 15 min | $46.04 | Plans negotiate; applies out of network | 35% | 2026 Fee Schedule - Covered Procedures R |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service) | $10.73since 1996-01-01 | 15 min | $42.92 | Plans negotiate; applies out of network | 33% | RI Medicaid Interactive Fee For Service |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $9.53since 2019-02-01 | 15 min | $38.12 | Not classified | 28% | CMAP fee schedule: DDS Specialized Servi |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma ODMHSAS state-funded behavioral health services (non-Medicaid 'State Rate') | $7.00since 2024-05-22 | 15 min | $28.00 | Not classified | — | ODMHSAS PICIS 'Rates and Codes for Agenc |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania OBRA Waiver (adults with developmental physical disabilities) | $6.50since 2026-07-01 | 15 min | $26.00 | Not classified | 20–21% | OLTL Home and Community Based Waiver Ser |
Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 97537?
It depends on the state. Of the 34 states with a published fee-for-service rate, the median is $25.54. New Jersey pays the most ($3,510.00 per 15 min) and Pennsylvania the least ($6.50 per 15 min).
Which state pays the highest Medicaid rate for 97537?
New Jersey, at $3,510.00 per 15 min ($14,040.00 per hour), effective 2025-12-01.
How do Medicaid rates for 97537 compare with Medicare?
Where the billing units match, Medicaid pays between 21% and 145% of the 2026 Medicare physician fee schedule amount for the state (non-facility).
Do managed-care plans pay the same rate for 97537?
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) · 50 states10006Physician and practitioner services (fee schedule) · 50 states10007Physician and practitioner services (fee schedule) · 50 states10008Physician and practitioner services (fee schedule) · 50 states10009Physician and practitioner services (fee schedule) · 50 states10010Physician and practitioner services (fee schedule) · 50 states10021Physician and practitioner services (fee schedule) · 50 states10030Physician and practitioner services (fee schedule) · 50 states10060Physician and practitioner services (fee schedule) · 50 states10061Physician and practitioner services (fee schedule) · 50 states10080Physician and practitioner services (fee schedule) · 50 states10081Physician and practitioner services (fee schedule) · 50 states
Track 97537 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.