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99218 Medicaid reimbursement rates by state

Physician and practitioner services (fee schedule). 7 state Medicaid programs publish a fee-for-service rate for 99218 at the physician psychologist level. Rates run from $30.30 in New York to $95.26 in Alabama, with a median of $67.40.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
7
Median rate
$67.40units vary by state
Highest
$95.26Alabama
Medicare (non-facility)
—not on the physician fee schedule

99218 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.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$95.26since 2016-10-01——Not classified—Physician Alabama Primary Care Enhanced
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$79.75since 2025-10-01——Not classified—Health First Colorado Physician Fee Sche
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$69.55since 2010-02-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$67.40since 2021-10-01——Plans negotiate; applies out of network—AHCCCS Arizona Health Care Cost Containm
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$60.29since 2017-01-01——Plans negotiate; applies out of network—Physician Maximum Allowed Fee Schedule -
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$56.10since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Nurse Practiti
New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid HIV Enhanced Fees for Physicians Program$30.30since 2022-04-01unit—Not classified—eMedNY Physician Enhanced Program Fee Sc

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 99218?

It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $67.40. Alabama pays the most ($95.26) and New York the least ($30.30 per unit).

Which state pays the highest Medicaid rate for 99218?

Alabama, at $95.26, effective 2016-10-01.

Do managed-care plans pay the same rate for 99218?

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 Physician & professional codes

Track 99218 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
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