G0537 Medicaid reimbursement rates by state
Administration of a standardized. 12 state Medicaid programs publish a fee-for-service rate for G0537 at the physician psychologist level. Rates run from $4.41 in New Jersey to $28.17 in Montana, with a median of $14.28.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 12
- Median rate
- $14.28units vary by state
- Highest
- $28.17Montana
- Medicare (non-facility)
- $18.39–$26.602026 physician fee schedule
G0537 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) | $28.17since 2026-07-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $17.36since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $17.04since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $16.22since 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) | $15.43since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $14.46since 2026-07-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $14.09since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $13.42since 2026-04-01 | — | — | Plans negotiate; applies out of network | — | BMS RBRVS 2026 Effective 4/1/26 - 3/31/2 |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $12.78since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Child and Adolescent Health Center |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $6.73since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | Appendix DD to OAC 5160-1-60 (Non-Instit |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $4.78since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Physician-related services fee sched |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $4.41since 2026-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
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 G0537?
It depends on the state. Of the 12 states with a published fee-for-service rate, the median is $14.28. Montana pays the most ($28.17) and New Jersey the least ($4.41).
Which state pays the highest Medicaid rate for G0537?
Montana, at $28.17, effective 2026-07-01.
Do managed-care plans pay the same rate for G0537?
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.