99474 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 20 state Medicaid programs publish a fee-for-service rate for 99474 at the physician psychologist level. Rates run from $5.78 in Virginia to $17.52 in Maryland, with a median of $9.89.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 20
- Median rate
- $9.89units vary by state
- Highest
- $17.52Maryland
- Medicare (non-facility)
- $16.70–$20.912026 physician fee schedule
99474 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 |
|---|---|---|---|---|---|---|
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $17.52since 2026-07-01 | — | — | Plans must pay at least this | — | Maryland Medicaid Professional Services |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $14.86since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $13.18since 2025-02-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Practitioner |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $13.10since 2025-07-01 | — | — | Plans must pay at least this | — | Louisiana Medicaid Professional Services |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $12.89since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $12.32since 2026-07-01 | — | — | Plans must pay at least this | — | NJMMIS Procedure Master Listing CPTHCPCS |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $11.72since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Certified Nurse Midwife Fee Schedu |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $10.92since 2020-09-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $10.84since 2026-01-01 | visit | — | Plans negotiate; applies out of network | 64% | KY Medicaid ST fee schedule (2026SpeechT |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $10.10since 2024-08-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| ArizonaPhysician or licensed psychologist (incl. BCBA-D) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $9.68since 2024-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| North CarolinaPhysician or licensed psychologist (incl. BCBA-D) · North Carolina Medicaid Direct (fee-for-service) | $9.15since 2025-10-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'ACA Physician |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $8.07since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $7.63since 2020-01-01 | — | — | Plans negotiate; applies out of network | — | OutPatient Site of Service (in Zipped Fe |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $7.44since 2023-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $6.73since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | Appendix DD to OAC 5160-1-60 (Non-Instit |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $6.48since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Emergency Adoption (date filed: Septembe |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $6.23since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Practitioner Fee Schedule (2026-01-01) |
| IllinoisPhysician or licensed psychologist (incl. BCBA-D) · Illinois Medicaid (HFS fee-for-service) | $5.83since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | CY 2025 Access Rule Comparative Analysis |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $5.78since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file cptmedical4.csv |
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 99474?
It depends on the state. Of the 20 states with a published fee-for-service rate, the median is $9.89. Maryland pays the most ($17.52) and Virginia the least ($5.78).
Which state pays the highest Medicaid rate for 99474?
Maryland, at $17.52, effective 2026-07-01.
How do Medicaid rates for 99474 compare with Medicare?
Where the billing units match, Medicaid pays between 64% and 64% of the 2026 Medicare physician fee schedule amount for the state (non-facility).
Do managed-care plans pay the same rate for 99474?
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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Track 99474 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.