Q4204 Medicaid reimbursement rates by state
Xwrap, per square centimeter (add-on. 6 state Medicaid programs publish a fee-for-service rate for Q4204 at the physician psychologist level. Rates run from $50.55 in Indiana to $3,774.77 in Texas, with a median of $88.22.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 6
- Median rate
- $88.22units vary by state
- Highest
- $3,774.77Texas
- Medicare (non-facility)
- $115.04–$134.642026 physician fee schedule
Q4204 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 |
|---|---|---|---|---|---|---|
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $3,774.77⚠ over 3× mediansince 2026-03-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $923.04⚠ over 3× mediansince 2025-10-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $92.95since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | ODM CPT/HCPCS procedure code changes for |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $83.49since 2026-01-01 | — | — | Not classified | — | SCDHHS Pediatric Subspecialty and Neonat |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $81.15since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Oral Maxillofacial Surgeon Fee Sch |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $50.55since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
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 Q4204?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $88.22. Texas pays the most ($3,774.77) and Indiana the least ($50.55 per unit).
Which state pays the highest Medicaid rate for Q4204?
Texas, at $3,774.77, effective 2026-03-01.
Do managed-care plans pay the same rate for Q4204?
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.