99053 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 9 state Medicaid programs publish a fee-for-service rate for 99053 at the physician psychologist level. Rates run from $5.00 in New Jersey to $26.48 in North Carolina, with a median of $12.87.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 9
- Median rate
- $12.87units vary by state
- Highest
- $26.48North Carolina
- Medicare (non-facility)
- —not on the physician fee schedule
99053 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 |
|---|---|---|---|---|---|---|
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $26.48since 2025-10-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Clinical Pharm |
| WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health) | $23.58since 2021-01-01 | — | — | Not classified | — | Wyoming Medicaid Downloadable Fee Schedu |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $21.54since 2026-01-01 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $16.13since 2022-07-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Podiatry |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $12.87since 2020-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $9.38since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service CPT |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $7.00since 2010-01-01 | — | — | Not classified | — | CMAP fee schedule: Physician Office and |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $6.69since 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) | $5.00since 2014-07-01 | — | — | 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 99053?
It depends on the state. Of the 9 states with a published fee-for-service rate, the median is $12.87. North Carolina pays the most ($26.48) and New Jersey the least ($5.00).
Which state pays the highest Medicaid rate for 99053?
North Carolina, at $26.48, effective 2025-10-01.
Do managed-care plans pay the same rate for 99053?
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.