99231 Medicaid reimbursement rates by state
Outpatient psychotherapy and diagnostic evaluation. 29 state Medicaid programs publish a fee-for-service rate for 99231 at the physician psychologist level. Rates run from $19.38 in Ohio to $533.58 in California, with a median of $33.27.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 29
- Median rate
- $33.27units vary by state
- Highest
- $533.58California
- Medicare (non-facility)
- —not on the physician fee schedule
99231 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) | $533.58⚠ over 3× mediansince 2026-07-01 | — | — | Paid by the state, outside plans | — | Medi-Cal Behavioral Health Fee Schedules |
| 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) | $51.12since 2025-08-01 | — | — | Paid by the state, outside plans | — | FY2027 PBHS Fee Schedule – Individual Pr |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $44.93since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| NebraskaPhysician or licensed psychologist (incl. BCBA-D) · Nebraska Medicaid (fee-for-service) | $42.11since 2026-07-01 | day | — | Plans negotiate; applies out of network | — | Nebraska Medicaid Mental Health and Subs |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $41.38since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| GeorgiaPhysician or licensed psychologist (incl. BCBA-D) · Georgia Medicaid (fee-for-service) | $38.98since 2020-08-14 | — | — | Plans negotiate; applies out of network | — | Max Allow Pymt Physician Enhanced Rate C |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $36.39since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Emergency Adoption (date filed: Septembe |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $36.29since 2024-07-01 | — | — | Not classified | — | SCDHHS Base Physician Fee Schedule (sche |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $36.04since 2026-01-01 | — | — | Plans must pay at least this | — | NJMMIS Procedure Master Listing CPTHCPCS |
| AlabamaPhysician or licensed psychologist (incl. BCBA-D) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $35.43since 2022-10-01 | — | — | Not classified | — | Rural Physician Fee Schedule |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $35.00since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $34.29since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Practitioner Fee Schedule (2026-01-01) |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $33.36since 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) | $33.32since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $33.27since 2025-10-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Nurse Practiti |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $32.84since 2016-01-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $32.80since 2024-04-01 | — | — | Plans negotiate; applies out of network | — | HFS Podiatrist Fee Schedule (effective 2 |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $32.21since 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) | $31.77since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file cptmedical4.csv |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $31.75since 2022-07-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Nurse Midwife |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $31.68since 2021-11-17 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| 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 |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $30.26since 2026-07-01 | — | — | Plans must pay at least this | — | HCA Enhanced adult primary care fee sche |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $30.06since 2021-08-23 | — | — | Plans negotiate; applies out of network | — | 51 Pa.B. 5914 Medical Assistance Program |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $29.75since 2026-01-01 | — | — | Not classified | — | CMAP fee schedule: Physician Office and |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $28.12since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Vision Fee Schedule database, Janu |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $25.89since 2020-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Physician fee schedule (2020 |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $20.62since 2020-01-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $19.38since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | Appendix DD to OAC 5160-1-60 (Non-Instit |
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 99231?
It depends on the state. Of the 29 states with a published fee-for-service rate, the median is $33.27. California pays the most ($533.58) and Ohio the least ($19.38).
Which state pays the highest Medicaid rate for 99231?
California, at $533.58, effective 2026-07-01.
Do managed-care plans pay the same rate for 99231?
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 99231 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.