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99426 Medicaid reimbursement rates by state

Physician and practitioner services (fee schedule). 22 state Medicaid programs publish a fee-for-service rate for 99426 at the physician psychologist level. Rates run from $11.61 in Kansas to $95.31 in Montana, with a median of $52.89.

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

States publishing
22
Median rate
$52.89units vary by state
Highest
$95.31Montana
Medicare (non-facility)
$63.57–$84.572026 physician fee schedule

99426 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
MontanaPhysician or licensed psychologist (incl. BCBA-D) · Montana Medicaid and HMK Plus (fee-for-service)$95.31since 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)$88.51since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$69.78since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$69.24since 2026-07-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$57.71since 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$56.92since 2022-01-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$56.45since 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)$55.31since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$54.44since 2026-02-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$54.41since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
ArizonaPhysician or licensed psychologist (incl. BCBA-D) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$53.98since 2024-10-01——Plans negotiate; applies out of network—AHCCCS Arizona Health Care Cost Containm
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$51.79since 2022-10-01——Plans negotiate; applies out of network—Copy of Schedule of Maximum Allw Pymt Ph
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$50.97since 2022-01-01——Plans negotiate; applies out of network—KY Medicaid Physician fee schedule (2022
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$49.21since 2024-09-01——Plans must pay at least this—2026 Fee Schedule - Covered Procedures R
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$48.67since 2026-06-01——Plans must pay at least this—Medicaid Fee-For-Service (FFS) Fee Sched
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$46.59since 2026-01-01——Not classified—MaineCare Fee Schedule (MaineCare UCR, H
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$43.24since 2026-01-01——Plans negotiate; applies out of network—MDHHS Certified Nurse Midwife Fee Schedu
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$42.04since 2022-01-01——Plans must pay at least this—Provider Type 77 Physician's Assistant R
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$35.99since 2026-10-01——Plans negotiate; applies out of network—Emergency Adoption (date filed: Septembe
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$33.38since 2026-07-01——Plans must pay at least this—NJMMIS Procedure Master Listing CPTHCPCS
PennsylvaniaRegistered nurse (RN) · Pennsylvania Medical Assistance (fee-for-service)$30.90since 2022-08-29——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$11.61since 2022-01-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched

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 99426?

It depends on the state. Of the 22 states with a published fee-for-service rate, the median is $52.89. Montana pays the most ($95.31) and Kansas the least ($11.61).

Which state pays the highest Medicaid rate for 99426?

Montana, at $95.31, effective 2026-07-01.

Do managed-care plans pay the same rate for 99426?

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 99426 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
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