99343 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 8 state Medicaid programs publish a fee-for-service rate for 99343 at the physician psychologist level. Rates run from $30.30 in New York to $150.80 in Ohio, with a median of $112.86.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 8
- Median rate
- $112.86units vary by state
- Highest
- $150.80Ohio
- Medicare (non-facility)
- —not on the physician fee schedule
99343 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 |
|---|---|---|---|---|---|---|
| OhioPhysician or licensed psychologist (incl. BCBA-D) · Ohio Medicaid (fee-for-service) | $150.80since 2024-01-01 | encounter | — | Plans expected to pay at least this | — | ODM Behavioral Health Coding Workbook (1 |
| AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $125.12since 2016-10-01 | — | — | Not classified | — | Physician Alabama Primary Care Enhanced |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $114.49since 2020-04-16 | — | — | Plans negotiate; applies out of network | — | Administrative Bulletin 20-27: 101 CMR 3 |
| North CarolinaPhysician or licensed psychologist (incl. BCBA-D) · North Carolina Medicaid Direct (fee-for-service) | $112.94since 2025-10-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Physician Serv |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $112.77since 2022-07-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $104.86since 2017-01-01 | — | — | Plans negotiate; applies out of network | — | OutPatient Max Allowed Site of Service F |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $53.42since 2019-09-11 | — | — | Plans negotiate; applies out of network | — | HFS Podiatrist Fee Schedule (effective 2 |
| 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 |
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 99343?
It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $112.86. Ohio pays the most ($150.80 per encounter) and New York the least ($30.30 per unit).
Which state pays the highest Medicaid rate for 99343?
Ohio, at $150.80 per encounter, effective 2024-01-01.
Do managed-care plans pay the same rate for 99343?
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.