Q4259 Medicaid reimbursement rates by state
Celera dual layer or celera dual membrane. 14 state Medicaid programs publish a fee-for-service rate for Q4259 at the physician psychologist level. Rates run from $50.55 in Indiana to $1,334.35 in Ohio, with a median of $154.52.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 14
- Median rate
- $154.52units vary by state
- Highest
- $1,334.35Ohio
- Medicare (non-facility)
- $115.04–$183.512026 physician fee schedule
Q4259 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 |
|---|---|---|---|---|---|---|
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $1,334.35⚠ over 3× mediansince 2024-07-01 | — | — | Plans negotiate; applies out of network | — | ODM provider-administered pharmaceutical |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $1,280.74⚠ over 3× mediansince 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $1,280.74⚠ over 3× mediansince 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $1,280.74⚠ over 3× mediansince 2025-04-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $713.50⚠ over 3× mediansince 2025-10-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service) | $713.50⚠ over 3× mediansince 2025-10-01 | — | — | 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 | $178.38since 2025-10-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $130.66since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $127.26since 2026-01-01 | — | — | Not classified | — | South Dakota Medicaid Physician fee sche |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $127.14since 2026-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| District of ColumbiaAny qualified provider (rate does not vary by provider) · DC Medicaid (DHCF) fee-for-service | $119.93since 2026-01-01 | — | — | Not classified | — | REFRP00178CSV - Medical Fee Schedule Rep |
| 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 Q4259?
It depends on the state. Of the 14 states with a published fee-for-service rate, the median is $154.52. Ohio pays the most ($1,334.35) and Indiana the least ($50.55 per unit).
Which state pays the highest Medicaid rate for Q4259?
Ohio, at $1,334.35, effective 2024-07-01.
Do managed-care plans pay the same rate for Q4259?
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.