A2042 Medicaid reimbursement rates by state
Foundation drs+ solo (add-on. 6 state Medicaid programs publish a fee-for-service rate for A2042 at the physician psychologist level. Rates run from $14.55 in Colorado to $1,500.60 in South Carolina, with a median of $87.05.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 6
- Median rate
- $87.05units vary by state
- Highest
- $1,500.60South Carolina
- Medicare (non-facility)
- $116.19–$135.402026 physician fee schedule
A2042 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 |
|---|---|---|---|---|---|---|
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $1,500.60⚠ over 3× mediansince 2026-04-01 | — | — | Plans negotiate; applies out of network | — | SCDHHS Nurse Midwives Fee Schedule (sche |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $178.88since 2026-04-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $92.95since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | ODM CPT/HCPCS procedure code changes for |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $81.15since 2026-04-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Oral Maxillofacial Surgeon Fee Sch |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $50.55since 2026-04-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $14.55since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
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 A2042?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $87.05. South Carolina pays the most ($1,500.60) and Colorado the least ($14.55).
Which state pays the highest Medicaid rate for A2042?
South Carolina, at $1,500.60, effective 2026-04-01.
Do managed-care plans pay the same rate for A2042?
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.