H0031 Medicaid reimbursement rates by state
Mental health assessment, by non-physician. 27 state Medicaid programs publish a fee-for-service rate for H0031 at the physician psychologist level. Rates run from $9.66 in Florida to $687.46 in Missouri, with a median of $107.44.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 27
- Median rate
- $107.44units vary by state
- Highest
- $687.46Missouri
- Medicare (non-facility)
- —not on the physician fee schedule
H0031 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 |
|---|---|---|---|---|---|---|
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $687.46⚠ over 3× mediansince 2022-07-01 | — | — | Paid by the state, outside plans | — | MO HealthNet fee schedule: Community Psy |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $400.00⚠ over 3× mediansince 2024-10-01 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule l |
| New JerseyPhysician or licensed psychologist (incl. BCBA-D) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $199.11since 2025-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $191.11since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | HCA Specialized mental health fee schedu |
| CaliforniaPhysician or licensed psychologist (incl. BCBA-D) · California Medi-Cal Specialty Mental Health Services (DHCS fee schedule for county Mental Health Plans) | $182.94since 2026-07-01 | — | — | Paid by the state, outside plans | — | Medi-Cal Behavioral Health Fee Schedules |
| MarylandCase manager / support coordinator · Maryland Public Behavioral Health System (specialty mental health, SUD and ABA, paid fee-for-service through the Carelon ASO) | $172.13since 2024-07-01 | — | — | Paid by the state, outside plans | — | FY2025 PBHS Fee Schedule – PRP and Speci |
| NebraskaPhysician or licensed psychologist (incl. BCBA-D) · Nebraska Medicaid (fee-for-service) | $164.25since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid Mental Health and Subs |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS behavioral health outpatient MCO capped fee schedule | $158.88since 2026-10-01 | — | — | Suggested schedule for plans | — | AHCCCS MCO Fee Schedule Final MCO Behavi |
| OklahomaPhysician or licensed psychologist (incl. BCBA-D) · Oklahoma SoonerCare (fee-for-service, OHCA) | $148.37since 2022-07-01 | — | — | Plans must pay at least this | — | ODMHSAS PICIS 'SoonerCare - Psychologist |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $135.00since 2007-07-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $127.34since 2024-07-01 | unit | — | Plans negotiate; applies out of network | — | OHP FFS behavioral health fee schedule ( |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $125.00since 2016-01-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| South CarolinaPhysician or licensed psychologist (incl. BCBA-D) · South Carolina Healthy Connections Medicaid (fee-for-service) | $118.46since 2026-07-01 | — | — | Not classified | — | SCDHHS Rehabilitative Behavioral Health |
| KentuckyPhysician or licensed psychologist (incl. BCBA-D) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $107.44since 2020-01-01 | encounter | — | Plans negotiate; applies out of network | — | DMS CMHC Mental Health Substance Abuse f |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $84.60since 2026-01-01 | — | — | Not classified | — | CMAP fee schedule: Behavioral Health Cli |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $82.44since 2019-01-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid Rehabilitation Option (MRO) community mental health services | $77.72since 2010-07-01 | unit | — | Paid by the state, outside plans | — | IHCP Professional Fee Schedule (Last Upd |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $74.25since 2024-01-01 | — | — | Plans must pay at least this | — | DMAS procedure fee file hcpcmedical.csv |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid School Program (school-based services) | $48.50since 2020-06-12 | — | — | Paid by the state, outside plans | — | Appendix DD to OAC 5160-1-60 (Non-Instit |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $42.67since 2026-09-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Practitioner and Medical Clinic Fe |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $38.10since 2025-08-11 | — | — | Paid by the state, outside plans | — | ForwardHealth max fee schedule: School B |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $30.73since 2024-10-01 | — | — | Plans must pay at least this | — | Rates for Applied Behavior Analysis (eff |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $28.91since 2026-03-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Outpa |
| North CarolinaPhysician or licensed psychologist (incl. BCBA-D) · North Carolina Medicaid Direct (fee-for-service) | $19.22since 2025-10-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Physician Serv |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $10.00since 2019-03-20 | — | — | Plans must pay at least this | — | Louisiana Medicaid EPSDT Health Services |
| AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $10.00since 2023-10-01 | 15 min | $40.00 | Not classified | — | Department of Mental Health Substance Us |
| FloridaPhysician or licensed psychologist (incl. BCBA-D) · Florida Medicaid (fee-for-service) | $9.66since 2026-01-01 | — | — | Paid by the state, outside plans | — | Medicaid Certified School Match Program |
Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 H0031?
It depends on the state. Of the 27 states with a published fee-for-service rate, the median is $107.44. Missouri pays the most ($687.46) and Florida the least ($9.66).
Which state pays the highest Medicaid rate for H0031?
Missouri, at $687.46, effective 2022-07-01.
Do managed-care plans pay the same rate for H0031?
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 Behavioral health codes
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Track H0031 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.