98016 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 18 state Medicaid programs publish a fee-for-service rate for 98016 at the physician psychologist level. Rates run from $6.82 in New Jersey to $17.30 in New York, with a median of $11.74.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 18
- Median rate
- $11.74units vary by state
- Highest
- $17.30New York
- Medicare (non-facility)
- $16.43–$19.842026 physician fee schedule
98016 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 YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service) | $17.30since 2025-01-01 | unit | — | Plans negotiate; applies out of network | — | eMedNY Physician Fee Schedule Sect 2 (Me |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $13.91since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $13.52since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Physician fee schedule (2025 |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $13.38since 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) | $13.25since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $12.63since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $12.36since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | Max Allow Payment_OutP Site of Service ( |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $12.14since 2025-01-01 | — | — | 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) | $11.92since 2025-10-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'ACA Nurse Prac |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $11.56since 2025-01-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Practitioner |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $11.23since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | Appendix DD to OAC 5160-1-60 (Non-Instit |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $11.19since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | Administrative Bulletin 25-03: 101 CMR 3 |
| ArizonaPhysician or licensed psychologist (incl. BCBA-D) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $11.10since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $11.08since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Vision Fee Schedule database, Janu |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $9.40since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file cptmedical4.csv |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $9.38since 2025-01-01 | — | — | Not classified | — | SCDHHS Base Physician Fee Schedule (sche |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $7.64since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Physician-related services fee sched |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $6.82since 2026-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
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 98016?
It depends on the state. Of the 18 states with a published fee-for-service rate, the median is $11.74. New York pays the most ($17.30 per unit) and New Jersey the least ($6.82).
Which state pays the highest Medicaid rate for 98016?
New York, at $17.30 per unit, effective 2025-01-01.
Do managed-care plans pay the same rate for 98016?
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 98016 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.