99213 Medicaid reimbursement rates by state
Return-patient office visit, level 3 of 5. 50 state Medicaid programs publish a fee-for-service rate for 99213 at the physician psychologist level. Rates run from $0.01 in Rhode Island to $444.65 in California, with a median of $74.07.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 50
- Median rate
- $74.07units vary by state
- Highest
- $444.65California
- Medicare (non-facility)
- $86.86–$120.132026 physician fee schedule
99213 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 |
|---|---|---|---|---|---|---|
| CaliforniaPhysician or licensed psychologist (incl. BCBA-D) · California Medi-Cal Specialty Mental Health Services (DHCS fee schedule for county Mental Health Plans) | $444.65⚠ over 3× mediansince 2026-07-01 | — | — | Paid by the state, outside plans | — | Medi-Cal Behavioral Health Fee Schedules |
| AlaskaPhysician or licensed psychologist (incl. BCBA-D) · Alaska Medicaid (fee-for-service, Department of Health) | $165.33since 2026-07-01 | — | — | Not classified | — | Alaska Medicaid Physician Fee Schedule S |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $133.81since 2026-07-01 | — | — | Not classified | — | 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) | $128.92since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service CPT |
| UtahPhysician or licensed psychologist (incl. BCBA-D) · Utah Medicaid (fee-for-service, Traditional plan) | $122.78since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| District of ColumbiaAny qualified provider (rate does not vary by provider) · DC Medicaid (DHCF) fee-for-service | $121.13since 2025-01-01 | — | — | Paid by the state, outside plans | — | REFRP00183CSV - Provider Type Fee Schedu |
| North DakotaAny qualified provider (rate does not vary by provider) · North Dakota Medicaid (fee-for-service) | $105.14since 2026-07-01 | — | — | Not classified | — | ND Medicaid Professional (General) Servi |
| MarylandPhysician or licensed psychologist (incl. BCBA-D) · Maryland Public Behavioral Health System (specialty mental health, SUD and ABA, paid fee-for-service through the Carelon ASO) | $94.62since 2026-03-01 | visit | — | Paid by the state, outside plans | — | FY2027 PBHS Fee Schedule – SUD_7.6.2026 |
| DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP) | $92.63since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | DMAP 2026 Physician Fee Schedule |
| MassachusettsPhysician or licensed psychologist (incl. BCBA-D) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $92.52since 2025-09-01 | — | — | Plans must pay at least this | — | Rates for Mental Health Services Provide |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $92.06since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| OhioAgency provider · Ohio Medicaid (fee-for-service) | $91.14since 2024-01-01 | encounter | — | Plans expected to pay at least this | 100% | OAC 5160-27-03 Appendix A, Community Beh |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $89.93since 2026-07-01 | — | — | Not classified | — | South Dakota Medicaid Physician fee sche |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $86.12since 2026-07-01 | — | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| NebraskaPhysician or licensed psychologist (incl. BCBA-D) · Nebraska Medicaid (fee-for-service) | $85.69since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid Mental Health and Subs |
| GeorgiaPhysician or licensed psychologist (incl. BCBA-D) · Georgia Medicaid (fee-for-service) | $83.82since 2025-07-01 | — | — | Plans negotiate; applies out of network | — | Schedule of Maximum Allow Pymt Physician |
| MichiganPhysician or licensed psychologist (incl. BCBA-D) · Michigan Medicaid (fee-for-service) | $83.77since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Physician Primary Care Rate Increa |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $83.62since 2026-07-01 | — | — | Plans must pay at least this | — | SoonerCare Title XIX Fee Schedule |
| WyomingAny qualified provider (rate does not vary by provider) · Wyoming Behavioral Health Center benefit plans (WDH Behavioral Health Division, not Medicaid) | $82.67since 2026-07-01 | — | — | Not classified | — | Wyoming Medicaid Downloadable Fee Schedu |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $80.62since 2024-07-01 | — | — | Not classified | — | CMAP fee schedule: Clinic and Outpatient |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $79.37since 2026-01-01 | — | — | Not classified | — | Vermont Medicaid Fee Schedule - CPT Code |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $78.87since 2026-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, Septembe |
| AlabamaPhysician or licensed psychologist (incl. BCBA-D) · Alabama Coordinated Health Network (primary care case management entities; payments made fee-for-service by the Alabama Medicaid Agency) | $78.19since 2025-10-01 | — | — | Not classified | — | ACHN Participation Rates (7.3G_ACHN_Part |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $76.54since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $74.15since 2026-07-01 | — | — | Plans must pay at least this | — | NJMMIS Procedure Master Listing CPTHCPCS |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $73.99since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $73.99since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| LouisianaPhysician or licensed psychologist (incl. BCBA-D) · Louisiana Medicaid (fee-for-service) | $72.76since 2025-07-01 | — | — | Plans must pay at least this | — | Specialized Behavioral Health Services f |
| MissouriPhysician or licensed psychologist (incl. BCBA-D) · Missouri MO HealthNet (fee-for-service) | $67.21since 2022-07-01 | — | — | Paid by the state, outside plans | — | MO HealthNet fee schedule: Community Psy |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $65.28since 2026-01-01 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $65.15since 2026-04-01 | — | — | Plans negotiate; applies out of network | — | BMS RBRVS 2026 Effective 4/1/26 - 3/31/2 |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service | $65.05since 2026-06-01 | — | — | Plans must pay at least this | — | Medicaid Fee-For-Service (FFS) Fee Sched |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $60.62since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $60.42since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| South CarolinaPhysician or licensed psychologist (incl. BCBA-D) · South Carolina Healthy Connections Medicaid (fee-for-service) | $58.11since 2025-12-01 | — | — | Not classified | — | SCDHHS RBHS Substance Use Services Fee S |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $57.88since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Medication for opioid use disorder f |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $55.91since 2020-01-01 | 15 min | — | Plans negotiate; applies out of network | — | DMS CMHC Mental Health Substance Abuse f |
| North CarolinaPhysician or licensed psychologist (incl. BCBA-D) · North Carolina Medicaid Direct (fee-for-service) | $50.41since 2025-10-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'ACA Physician |
| ArizonaPhysician or licensed psychologist (incl. BCBA-D) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $48.68since 2024-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $47.47since 2023-02-06 | — | — | Plans must pay at least this | — | Provider Type 72 Nurse Anesthetist Reimb |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $47.34since 2025-06-13 | — | — | Not classified | — | Arkansas Medicaid Nurse Practitioner Fee |
| IllinoisPhysician or licensed psychologist (incl. BCBA-D) · Illinois Medicaid (HFS fee-for-service) | $44.67since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | CY 2025 Access Rule Comparative Analysis |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $43.23since 2024-01-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $42.07since 2023-07-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $41.44since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file cptmedical4.csv |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $36.71since 2023-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Certi |
| New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid HIV Enhanced Fees for Physicians Program | $36.36since 2022-04-01 | unit | — | Not classified | — | eMedNY Physician Enhanced Program Fee Sc |
| PennsylvaniaRegistered nurse (RN) · Pennsylvania Medical Assistance (fee-for-service) | $35.00since 2021-09-01 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $32.58since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Practitioner Fee Schedule (2026-01-01) |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid behavioral health programs (CMHC, ACT, BH Link, peer, SUD, health homes; fee-for-service) | $0.01since 2016-01-01 | — | — | Plans negotiate; applies out of network | — | RI Medicaid Interactive Fee For Service |
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 99213?
It depends on the state. Of the 50 states with a published fee-for-service rate, the median is $74.07. California pays the most ($444.65) and Rhode Island the least ($0.01).
Which state pays the highest Medicaid rate for 99213?
California, at $444.65, effective 2026-07-01.
How do Medicaid rates for 99213 compare with Medicare?
Where the billing units match, Medicaid pays between 100% and 100% of the 2026 Medicare physician fee schedule amount for the state (non-facility).
Do managed-care plans pay the same rate for 99213?
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 Behavioral health codes
90791Mental health assessment (non-physician) · 50 states90832Outpatient psychotherapy and diagnostic evaluation · 50 states90834Outpatient psychotherapy and diagnostic evaluation · 50 states90837Outpatient psychotherapy and diagnostic evaluation · 50 states90847Outpatient psychotherapy and diagnostic evaluation · 50 states90853Outpatient psychotherapy and diagnostic evaluation · 50 states96130Mental health assessment (non-physician) · 50 states96131Mental health assessment (non-physician) · 50 states96136Mental health assessment (non-physician) · 50 states96137Mental health assessment (non-physician) · 50 states99202New-patient office visit, level 1 of 4 · 50 states99203New-patient office visit, level 2 of 4 · 50 states
Track 99213 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.