G0403 Medicaid reimbursement rates by state
Consultative clinical assessment (IDD). 6 state Medicaid programs publish a fee-for-service rate for G0403 at the physician psychologist level. Rates run from $4.78 in Kansas to $79.53 in Texas, with a median of $11.72.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 6
- Median rate
- $11.72units vary by state
- Highest
- $79.53Texas
- Medicare (non-facility)
- $14.17–$15.862026 physician fee schedule
G0403 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 |
|---|---|---|---|---|---|---|
| TexasAgency provider · Texas Community Living Assistance and Support Services (CLASS) waiver | $79.53since 2025-09-01 | hour | $79.53 | Paid by the state, outside plans | — | HHSC PFD CLASS payment rates (9-1-2025-c |
| MontanaPhysician or licensed psychologist (incl. BCBA-D) · Montana Medicaid and HMK Plus (fee-for-service) | $21.60since 2026-07-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $11.87since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $11.57since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service) | $10.94since 2009-01-01 | — | — | Plans negotiate; applies out of network | — | RI Medicaid Interactive Fee For Service |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $4.78since 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 G0403?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $11.72. Texas pays the most ($79.53 per hour) and Kansas the least ($4.78).
Which state pays the highest Medicaid rate for G0403?
Texas, at $79.53 per hour ($79.53 per hour), effective 2025-09-01.
Do managed-care plans pay the same rate for G0403?
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.