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G0166 Medicaid reimbursement rates by state

External counterpulsation, per treatment session. 17 state Medicaid programs publish a fee-for-service rate for G0166 at the physician psychologist level. Rates run from $34.52 in Kansas to $144.49 in Wisconsin, with a median of $83.67.

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

States publishing
17
Median rate
$83.67units vary by state
Highest
$144.49Wisconsin
Medicare (non-facility)
$87.91–$125.682026 physician fee schedule

G0166 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
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$144.49since 2008-07-01——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)$142.64since 2024-01-01——Plans must pay at least this—Provider Type 20 Physician, MD., Osteopa
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$105.52since 2026-10-01——Plans negotiate; applies out of network—AHCCCS Arizona Health Care Cost Containm
PennsylvaniaPhysician or licensed psychologist (incl. BCBA-D) · Pennsylvania Medical Assistance (fee-for-service)$103.05since 2015-09-01——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
ArkansasPhysician or licensed psychologist (incl. BCBA-D) · Arkansas Medicaid (fee-for-service)$102.38since 2025-06-13——Not classified—Arkansas Medicaid Physician / CRNA / Fam
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$88.91since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$85.87since 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)$84.88since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$83.67since 2026-02-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$82.33since 2026-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$80.79since 2026-02-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$80.01since 2026-01-01——Plans negotiate; applies out of network—Practitioner Fee Schedule (2026-01-01)
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$64.90since 2013-01-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$64.78since 2026-07-01——Plans negotiate; applies out of network—HCA Physician-related services fee sched
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$52.23since 2024-07-01——Plans negotiate; applies out of network—SCDHHS Nurse Midwives Fee Schedule (sche
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$45.36since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$34.52since 2009-12-18——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 G0166?

It depends on the state. Of the 17 states with a published fee-for-service rate, the median is $83.67. Wisconsin pays the most ($144.49) and Kansas the least ($34.52).

Which state pays the highest Medicaid rate for G0166?

Wisconsin, at $144.49, effective 2008-07-01.

Do managed-care plans pay the same rate for G0166?

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 G0166 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
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