99221 Medicaid reimbursement rates by state

Outpatient psychotherapy and diagnostic evaluation. 32 state Medicaid programs publish a fee-for-service rate for 99221 at the physician psychologist level. Rates run from $28.60 in Arkansas to $835.94 in California, with a median of $60.59.

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

States publishing: 32
Median rate: $60.59units vary by state
Highest: $835.94California
Medicare (non-facility): —not on the physician fee schedule

99221 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)	$835.94⚠ over 3× mediansince 2026-07-01	—	—	Paid by the state, outside plans	—	Medi-Cal Behavioral Health Fee Schedules
GeorgiaPhysician or licensed psychologist (incl. BCBA-D) · Georgia Medicaid (fee-for-service)	$100.85since 2020-08-14	—	—	Plans negotiate; applies out of network	—	Max Allow Pymt Physician Enhanced Rate C
AlabamaPhysician or licensed psychologist (incl. BCBA-D) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)	$89.96since 2022-10-01	—	—	Not classified	—	Rural Physician Fee Schedule
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)	$86.51since 2025-08-01	—	—	Paid by the state, outside plans	—	FY2027 PBHS Fee Schedule – Individual Pr
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)	$82.38since 2022-07-01	—	—	Plans must pay at least this	—	MO HealthNet fee schedule: Nurse Midwife
North CarolinaPhysician or licensed psychologist (incl. BCBA-D) · North Carolina Medicaid Direct (fee-for-service)	$80.56since 2025-10-01	—	—	Plans must pay at least this	—	NC Medicaid fee schedule 'Physician Serv
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)	$79.00since 2021-08-23	—	—	Plans negotiate; applies out of network	—	51 Pa.B. 5914 Medical Assistance Program
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)	$75.08since 2026-01-01	unit	—	Plans must pay at least this	—	IHCP Professional Fee Schedule (Last Upd
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)	$69.71since 2026-10-01	—	—	Plans negotiate; applies out of network	—	AHCCCS Arizona Health Care Cost Containm
NebraskaPhysician or licensed psychologist (incl. BCBA-D) · Nebraska Medicaid (fee-for-service)	$68.13since 2026-07-01	day	—	Plans negotiate; applies out of network	—	Nebraska Medicaid Mental Health and Subs
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)	$67.04since 2026-07-01	—	—	Plans must pay at least this	—	SoonerCare Title XIX Fee Schedule
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)	$66.79since 2026-07-01	—	—	Plans negotiate; applies out of network	—	Child Health Plan Plus FY 2026-2027 Fee
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)	$64.96since 2023-07-01	—	—	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)	$60.97since 2024-08-01	—	—	Paid by the state, outside plans	—	KMAP Fee Schedule MKN Medicaid (FeeSched
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)	$60.92since 2026-10-01	—	—	Plans negotiate; applies out of network	—	Emergency Adoption (date filed: Septembe
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)	$60.63since 2020-01-01	—	—	Plans negotiate; applies out of network	—	ForwardHealth max fee schedule: Medical-
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)	$60.55since 2024-07-01	—	—	Not classified	—	SCDHHS Base Physician Fee Schedule (sche
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)	$60.09since 2025-04-01	—	—	Plans negotiate; applies out of network	—	HFS Podiatrist Fee Schedule (effective 2
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)	$59.92since 2021-11-17	—	—	Plans negotiate; applies out of network	—	TMHP Texas Medicaid Fee Schedule - Physi
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)	$58.70since 2026-02-01	—	—	Plans negotiate; applies out of network	—	OHP FFS medical-dental fee schedule (fee
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)	$58.28since 2005-07-01	—	—	Not classified	—	CMAP fee schedule: 9/1/2014 Dental Fee S
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)	$57.93since 2026-01-01	—	—	Plans negotiate; applies out of network	—	Practitioner Fee Schedule (2026-01-01)
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)	$55.10since 2026-02-01	—	—	Plans negotiate; applies out of network	—	MHCP Fee Schedule - Current Fee Schedule
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)	$53.86since 2025-07-01	—	—	Plans must pay at least this	—	Specialized Behavioral Health Services f
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)	$53.67since 2026-07-01	—	—	Plans negotiate; applies out of network	—	DMAS procedure fee file cptmedical4.csv
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)	$51.66since 2020-01-01	—	—	Plans negotiate; applies out of network	—	KY Medicaid Physician fee schedule (2020
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)	$51.64since 2025-07-01	—	—	Plans must pay at least this	—	NJMMIS Procedure Master Listing CPTHCPCS
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service	$50.88since 2026-07-01	—	—	Plans must pay at least this	—	HCA Enhanced adult primary care fee sche
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)	$50.35since 2024-01-01	—	—	Plans negotiate; applies out of network	—	Appendix DD to OAC 5160-1-60 (Non-Instit
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)	$47.50since 2026-01-01	—	—	Plans negotiate; applies out of network	—	MDHHS Vision Fee Schedule database, Janu
New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid HIV Enhanced Fees for Physicians Program	$30.30since 2022-04-01	unit	—	Not classified	—	eMedNY Physician Enhanced Program Fee Sc
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)	$28.60since 2025-05-15	—	—	Not classified	—	Arkansas Medicaid Oral Surgeon Fee Sched

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 99221?

It depends on the state. Of the 32 states with a published fee-for-service rate, the median is $60.59. California pays the most ($835.94) and Arkansas the least ($28.60).

Which state pays the highest Medicaid rate for 99221?

California, at $835.94, effective 2026-07-01.

Do managed-care plans pay the same rate for 99221?

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

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