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99354 Medicaid reimbursement rates by state

Physician and practitioner services (fee schedule). 9 state Medicaid programs publish a fee-for-service rate for 99354 at the licensed clinician level. Rates run from $60.68 in Kentucky to $107.43 in Arizona, with a median of $90.61.

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

States publishing
9
Median rate
$90.61units vary by state
Highest
$107.43Arizona
Medicare (non-facility)
—not on the physician fee schedule

99354 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
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$107.43since 2021-10-01——Plans negotiate; applies out of network—AHCCCS Arizona Health Care Cost Containm
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$107.02since 2025-07-01——Not classified—Health First Colorado Physician Fee Sche
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$99.89since 2014-01-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
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
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$90.61since 2017-01-01——Plans negotiate; applies out of network—Physician Maximum Allowed Fee Schedule -
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$76.42since 2024-01-01hour$76.42Plans expected to pay at least this—ODM Behavioral Health Coding Workbook (1
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$75.47since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Nurse Practiti
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$73.50since 2022-01-01——Plans negotiate; applies out of network—MDHHS Telemedicine, January 2022
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$60.68since 2020-01-0130-60 Min—Plans negotiate; applies out of network—DMS CMHC Mental Health Substance Abuse f

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 99354?

It depends on the state. Of the 9 states with a published fee-for-service rate, the median is $90.61. Arizona pays the most ($107.43) and Kentucky the least ($60.68 per 30-60 Min).

Which state pays the highest Medicaid rate for 99354?

Arizona, at $107.43, effective 2021-10-01.

Do managed-care plans pay the same rate for 99354?

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 99354 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
Medicaid rates by state