99355 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 9 state Medicaid programs publish a fee-for-service rate for 99355 at the licensed clinician level. Rates run from $53.09 in Michigan to $97.90 in Illinois, with a median of $79.23.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 9
- Median rate
- $79.23units vary by state
- Highest
- $97.90Illinois
- Medicare (non-facility)
- —not on the physician fee schedule
99355 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 |
|---|---|---|---|---|---|---|
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $97.90since 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) | $93.35since 2016-10-01 | — | — | Not classified | — | Physician Alabama Primary Care Enhanced |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $88.37since 2017-01-01 | — | — | Plans negotiate; applies out of network | — | Physician Maximum Allowed Fee Schedule - |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $80.53since 2022-07-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $79.23since 2021-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $75.85since 2024-01-01 | Additional 30 Minutes | — | Plans 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) | $74.71since 2025-10-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Nurse Practiti |
| KentuckyLicensed mental health clinician (LCSW, LMFT, LPC, licensed practitioner) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $55.99since 2020-01-01 | 15-30 Min | — | Plans negotiate; applies out of network | — | DMS CMHC Mental Health Substance Abuse f |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $53.09since 2022-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Telemedicine, January 2022 |
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 99355?
It depends on the state. Of the 9 states with a published fee-for-service rate, the median is $79.23. Illinois pays the most ($97.90) and Michigan the least ($53.09).
Which state pays the highest Medicaid rate for 99355?
Illinois, at $97.90, effective 2014-01-01.
Do managed-care plans pay the same rate for 99355?
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.