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99386 Medicaid reimbursement rates by state

Physician and practitioner services (fee schedule). 40 state Medicaid programs publish a fee-for-service rate for 99386 at the physician psychologist level. Rates run from $32.70 in Kansas to $397.00 in Pennsylvania, with a median of $109.66.

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

States publishing
40
Median rate
$109.66units vary by state
Highest
$397.00Pennsylvania
Medicare (non-facility)
—not on the physician fee schedule

99386 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
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$397.00⚠ over 3× mediansince 2005-10-01——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$218.79since 2026-07-01——Not classified—Montana Healthcare Programs fee schedule
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$211.25since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$154.01since 2026-01-01——Plans must pay at least this—Maryland Medicaid Professional Services
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$137.65since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$137.39since 2026-07-01——Plans must pay at least this—SoonerCare Title XIX Fee Schedule
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$134.72since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$132.20since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service)$130.73since 2025-10-01unit—Plans negotiate; applies out of network—eMedNY Physician Fee Schedule Sect 2 (Me
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$129.80since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$129.73since 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - CPT Code
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$129.26since 2025-09-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$125.05since 2026-02-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$122.89since 2024-01-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$120.96since 2026-02-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$119.26since 2026-10-01——Plans negotiate; applies out of network—Emergency Adoption (date filed: Septembe
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$118.35since 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$116.70since 2020-01-01——Plans negotiate; applies out of network—KY Medicaid Physician fee schedule (2020
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$112.99since 2008-07-01——Not classified—CMAP fee schedule: Clinic - Medical 4/1/
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$110.08since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Clinical Pharm
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$109.24since 2026-07-01——Plans negotiate; applies out of network—HCA Family planning fee schedule (family
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$108.85since 2024-07-01——Not classified—SCDHHS Base Physician Fee Schedule (sche
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$107.10since 2026-01-01——Not classified—MaineCare Fee Schedule (MaineCare UCR, H
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$106.87since 2026-04-01——Plans negotiate; applies out of network—BMS RBRVS 2026 Effective 4/1/26 - 3/31/2
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$104.86since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
MichiganPhysician or licensed psychologist (incl. BCBA-D) · Michigan Medicaid (fee-for-service)$104.46since 2023-01-01——Plans negotiate; applies out of network—MDHHS Physician Primary Care Rate Increa
ArizonaPhysician or licensed psychologist (incl. BCBA-D) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$102.40since 2024-10-01——Plans negotiate; applies out of network—AHCCCS Arizona Health Care Cost Containm
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$100.03since 2024-01-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$98.99since 2018-09-01——Plans must pay at least this—Provider Type 77 Physician's Assistant R
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$94.10since 2021-11-17——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$89.97since 2013-02-01——Plans must pay at least this—Louisiana Medicaid Professional Services
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$81.41since 2025-07-01——Plans must pay at least this—NJMMIS Procedure Master Listing CPTHCPCS
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$77.89since 2026-01-01——Plans negotiate; applies out of network—Practitioner Fee Schedule (2026-01-01)
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$75.38since 2017-01-01——Plans negotiate; applies out of network—Physician Maximum Allowed Fee Schedule -
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$72.04since 2026-07-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical4.csv
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$62.29since 2024-01-01——Plans negotiate; applies out of network—Appendix DD to OAC 5160-1-60 (Non-Instit
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$52.42since 2022-07-01——Plans must pay at least this—MO HealthNet fee schedule: Nurse Midwife
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$44.15since 2023-07-01——Plans must pay at least this—2026 Fee Schedule - Covered Procedures R
IllinoisPhysician or licensed psychologist (incl. BCBA-D) · Illinois Medicaid (HFS fee-for-service)$38.56since 2025-01-01——Plans negotiate; applies out of network—CY 2025 Access Rule Comparative Analysis
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$32.70since 2024-08-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched

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 99386?

It depends on the state. Of the 40 states with a published fee-for-service rate, the median is $109.66. Pennsylvania pays the most ($397.00) and Kansas the least ($32.70).

Which state pays the highest Medicaid rate for 99386?

Pennsylvania, at $397.00, effective 2005-10-01.

Do managed-care plans pay the same rate for 99386?

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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Medicaid rates by state
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