G0402 Medicaid reimbursement rates by state
Initial preventive physical examination; face-to-face visit. 6 state Medicaid programs publish a fee-for-service rate for G0402 at the physician psychologist level. Rates run from $23.17 in Kansas to $245.55 in Montana, with a median of $98.30.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 6
- Median rate
- $98.30units vary by state
- Highest
- $245.55Montana
- Medicare (non-facility)
- $163.98–$179.742026 physician fee schedule
G0402 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 |
|---|---|---|---|---|---|---|
| MontanaPhysician or licensed psychologist (incl. BCBA-D) · Montana Medicaid and HMK Plus (fee-for-service) | $245.55since 2026-07-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $133.28since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $120.31since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| TexasSpeech-language pathologist · Texas Community Living Assistance and Support Services (CLASS) waiver | $76.29since 2024-09-01 | hour | $76.29 | Paid by the state, outside plans | — | HHSC PFD CLASS payment rates (09-2024-cl |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $66.67since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $23.17since 2009-01-01 | — | — | 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 G0402?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $98.30. Montana pays the most ($245.55) and Kansas the least ($23.17).
Which state pays the highest Medicaid rate for G0402?
Montana, at $245.55, effective 2026-07-01.
Do managed-care plans pay the same rate for G0402?
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.