97763 Medicaid reimbursement rates by state
Follow-up visit for a brace or artificial limb. 27 state Medicaid programs publish a fee-for-service rate for 97763 at the physician psychologist level. Rates run from $17.37 in Kentucky to $72.32 in New Mexico, with a median of $40.79.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 27
- Median rate
- $40.79units vary by state
- Highest
- $72.32New Mexico
- Medicare (non-facility)
- $45.33–$58.502026 physician fee schedule
97763 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) | $72.32since 2025-01-01 | 15 min | $289.28 | Plans must pay at least this | 153% | 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) | $52.05since 2026-10-01 | 15 min | $208.20 | Plans negotiate; applies out of network | 106% | AHCCCS Arizona Health Care Cost Containm |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $48.80since 2026-07-01 | 15 min | $195.20 | Plans negotiate; applies out of network | 103% | Nebraska Medicaid fee schedule 471-000-5 |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $47.30since 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) | $44.24since 2024-01-01 | 15 min | $176.96 | Plans must pay at least this | 88% | Provider Type 20 Physician, MD., Osteopa |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $43.61since 2018-01-01 | 15 min | $174.44 | Plans must pay at least this | 93% | Iowa Medicaid fee schedule #02 PHYSICIAN |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $43.46since 2026-07-01 | 15 min | $173.84 | Plans must pay at least this | 94% | SoonerCare Title XIX Fee Schedule |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $43.40since 2026-07-01 | 15 min | $173.60 | Plans negotiate; applies out of network | 88% | DMAS procedure fee file cptmedical4.csv |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $43.34since 2026-07-01 | 15 min | $173.36 | Plans negotiate; applies out of network | 83% | Child Health Plan Plus FY 2026-2027 Fee |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $41.69since 2018-01-01 | 15 min | $166.76 | Plans negotiate; applies out of network | 82–90% | Schedule of Maximum Allw Pymt Physician |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $41.42since 2026-10-01 | 15 min | $165.68 | Plans negotiate; applies out of network | 72–80% | Emergency Adoption (date filed: Septembe |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $40.98since 2018-01-01 | 15 min | $163.92 | Plans must pay at least this | 85–89% | Louisiana Medicaid Professional Services |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $40.80since 2026-07-01 | 15 min | $163.20 | Plans must pay at least this | 90% | DOM Comprehensive Fee Schedule, Septembe |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $40.79since 2022-07-01 | 15 min | $163.16 | Plans must pay at least this | 84–90% | MO HealthNet fee schedule: Practitioner |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $40.66since 2026-02-01 | 15 min | $162.64 | Plans negotiate; applies out of network | 75–82% | OHP FFS medical-dental fee schedule (fee |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $40.56since 2026-01-01 | 15 min | $162.24 | Not classified | 76% | CMAP fee schedule: Independent Physical |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $40.00since 2025-10-01 | 15 min | $160.00 | Paid by the state, outside plans | 84% | NC Medicaid fee schedule 'Children Devel |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $39.10since 2026-02-01 | 15 min | $156.40 | Plans negotiate; applies out of network | 77% | MHCP Fee Schedule - Current Fee Schedule |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid School Program (school-based services) | $37.24since 2020-06-12 | 15 min | $148.96 | Paid by the state, outside plans | 79% | 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) | $37.13since 2018-01-01 | 15 min | $148.52 | Plans negotiate; applies out of network | 78% | SCDHHS Nurse Midwives Fee Schedule (sche |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $32.36since 2024-08-01 | 15 min | $129.44 | Paid by the state, outside plans | 69% | KMAP Fee Schedule MKN Medicaid (FeeSched |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $31.95since 2026-01-01 | 15 min | $127.80 | Plans negotiate; applies out of network | 65–68% | MDHHS Occupational Therapy Fee Schedule |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $30.77since 2026-07-01 | 15 min | $123.08 | Plans negotiate; applies out of network | 53–59% | HCA Habilitative services fee schedule ( |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $28.53since 2019-09-01 | 15 min | $114.12 | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $28.15since 2018-01-01 | 15 min | $112.60 | Plans negotiate; applies out of network | 58% | ForwardHealth max fee schedule: Therapy- |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $21.76since 2026-07-01 | 15 min | $87.04 | Not classified | 38–40% | NJMMIS Procedure Master Listing CPTHCPCS |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $17.37since 2026-01-01 | 15 min | $69.48 | 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 97763?
It depends on the state. Of the 27 states with a published fee-for-service rate, the median is $40.79. New Mexico pays the most ($72.32 per 15 min) and Kentucky the least ($17.37 per 15 min).
Which state pays the highest Medicaid rate for 97763?
New Mexico, at $72.32 per 15 min ($289.28 per hour), effective 2025-01-01.
How do Medicaid rates for 97763 compare with Medicare?
Where the billing units match, Medicaid pays between 37% and 153% of the 2026 Medicare physician fee schedule amount for the state (non-facility).
Do managed-care plans pay the same rate for 97763?
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 97763 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.