97804 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 21 state Medicaid programs publish a fee-for-service rate for 97804 at the physician psychologist level. Rates run from $4.64 in Kentucky to $18.08 in Nebraska, with a median of $13.00.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 21
- Median rate
- $13.00units vary by state
- Highest
- $18.08Nebraska
- Medicare (non-facility)
- $16.06–$21.492026 physician fee schedule
97804 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 |
|---|---|---|---|---|---|---|
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $18.08since 2026-07-01 | 30 min | $36.16 | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $14.71since 2026-01-01 | 30 min | $29.42 | Not classified | 82–86% | Maryland Medicaid Professional Services |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $14.21since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| TexasRegistered nurse (RN) · Texas Medicaid (fee-for-service, TMHP) | $14.03since 2023-09-01 | 30 min | $28.06 | Plans negotiate; applies out of network | 80–86% | TMHP Texas Medicaid Fee Schedule - Thste |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $13.91since 2026-10-01 | 30 min | $27.82 | Plans negotiate; applies out of network | 65–78% | Medi-Cal Rates (Rates files zip: rates_d |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $13.86since 2026-07-01 | 30 min | $27.72 | Plans negotiate; applies out of network | 79% | Child Health Plan Plus FY 2026-2027 Fee |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $13.74since 2026-02-01 | 30 min | $27.48 | Plans negotiate; applies out of network | 76–81% | OHP FFS medical-dental fee schedule (fee |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $13.34since 2025-07-01 | 30 min | $26.68 | Plans must pay at least this | 80–83% | Louisiana Medicaid Professional Services |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $13.12since 2026-02-01 | 30 min | $26.24 | Plans negotiate; applies out of network | 77% | MHCP Fee Schedule - Current Fee Schedule |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $13.10since 2026-10-01 | 30 min | $26.20 | Plans negotiate; applies out of network | 78% | AHCCCS Arizona Health Care Cost Containm |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $13.00since 2026-10-01 | 30 min | $26.00 | Plans negotiate; applies out of network | — | Part II Policies and Procedures for Chil |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $11.73since 2025-07-01 | 30 min | $23.46 | Not classified | 65% | CMAP fee schedule: Clinic - Medical 4/1/ |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $11.68since 2026-10-01 | 30 min | $23.36 | Plans negotiate; applies out of network | 62–67% | Emergency Adoption (date filed: Septembe |
| New YorkDietitian / nutritionist · New York Medicaid (fee-for-service) | $11.50since 2024-01-01 | 30 min | $23.00 | Not classified | 59–70% | eMedNY NYS Medicaid Medical Nutritional |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $11.10since 2024-07-01 | 30 min | $22.20 | Not classified | — | SCDHHS Base Physician Fee Schedule (sche |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $10.71since 2026-07-01 | 30 min | $21.42 | Plans negotiate; applies out of network | 64% | DMAS procedure fee file cptmedical4.csv |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $8.63since 2026-07-01 | 30 min | $17.26 | Not classified | 46–47% | NJMMIS Procedure Master Listing CPTHCPCS |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $8.61since 2024-01-01 | 30 min | $17.22 | Plans negotiate; applies out of network | 53% | Appendix DD to OAC 5160-1-60 (Non-Instit |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $7.45since 2026-07-01 | 30 min | $14.90 | Plans negotiate; applies out of network | 39–43% | HCA Medical nutrition therapy fee schedu |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $5.94since 2024-01-01 | 30 min | $11.88 | Plans must pay at least this | 37% | Iowa Medicaid fee schedule #02 PHYSICIAN |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $4.64since 2020-01-01 | 30 min | $9.28 | Plans negotiate; applies out of network | 29% | KY Medicaid Physician fee schedule (2020 |
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 97804?
It depends on the state. Of the 21 states with a published fee-for-service rate, the median is $13.00. Nebraska pays the most ($18.08 per 30 min) and Kentucky the least ($4.64 per 30 min).
Which state pays the highest Medicaid rate for 97804?
Nebraska, at $18.08 per 30 min ($36.16 per hour), effective 2026-07-01.
How do Medicaid rates for 97804 compare with Medicare?
Where the billing units match, Medicaid pays between 29% and 84% of the 2026 Medicare physician fee schedule amount for the state (non-facility).
Do managed-care plans pay the same rate for 97804?
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 97804 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.