G0513 Medicaid reimbursement rates by state
Prolonged preventive service(s). 11 state Medicaid programs publish a fee-for-service rate for G0513 at the physician psychologist level. Rates run from $14.52 in Kansas to $91.08 in Montana, with a median of $51.93.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 11
- Median rate
- $51.93units vary by state
- Highest
- $91.08Montana
- Medicare (non-facility)
- $61.39–$71.162026 physician fee schedule
G0513 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 |
|---|---|---|---|---|---|---|
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $91.08since 2026-07-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service | $58.07since 2026-06-01 | — | — | Plans negotiate; applies out of network | — | Medicaid Fee-For-Service (FFS) Fee Sched |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $57.71since 2026-01-01 | — | — | Plans must pay at least this | — | Louisiana Medicaid Enhanced Professional |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $55.21since 2018-01-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $54.15since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $51.93since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $50.11since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $44.48since 2018-01-01 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $39.63since 2018-01-01 | — | — | Plans must pay at least this | — | Provider Type 17, Specialty 166, Special |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $25.38since 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 | $14.52since 2018-01-01 | — | — | 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 G0513?
It depends on the state. Of the 11 states with a published fee-for-service rate, the median is $51.93. Montana pays the most ($91.08) and Kansas the least ($14.52).
Which state pays the highest Medicaid rate for G0513?
Montana, at $91.08, effective 2026-07-01.
Do managed-care plans pay the same rate for G0513?
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.