99251 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 7 state Medicaid programs publish a fee-for-service rate for 99251 at the physician psychologist level. Rates run from $27.86 in Rhode Island to $47.62 in Alabama, with a median of $38.10.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 7
- Median rate
- $38.10units vary by state
- Highest
- $47.62Alabama
- Medicare (non-facility)
- —not on the physician fee schedule
99251 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 |
|---|---|---|---|---|---|---|
| AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $47.62since 2016-10-01 | — | — | Not classified | — | Physician Alabama Primary Care Enhanced |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $47.29since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Physician Pediatric Surgery Fee Schedule |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $39.60since 2025-10-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Nurse Practiti |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $38.10since 2017-01-01 | — | — | Plans negotiate; applies out of network | — | Physician Maximum Allowed Fee Schedule - |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $32.15since 2010-02-01 | — | — | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $27.93since 2020-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Telemedicine, January 2020 |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service) | $27.86since 1993-04-01 | — | — | Plans negotiate; applies out of network | — | RI Medicaid Interactive Fee For 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 99251?
It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $38.10. Alabama pays the most ($47.62) and Rhode Island the least ($27.86).
Which state pays the highest Medicaid rate for 99251?
Alabama, at $47.62, effective 2016-10-01.
Do managed-care plans pay the same rate for 99251?
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.