90838 Medicaid reimbursement rates by state
Outpatient psychotherapy and diagnostic evaluation. 40 state Medicaid programs publish a fee-for-service rate for 90838 at the physician psychologist level. Rates run from $0.01 in Rhode Island to $1,070.36 in California, with a median of $112.63.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 40
- Median rate
- $112.63units vary by state
- Highest
- $1,070.36California
- Medicare (non-facility)
- $129.44–$161.642026 physician fee schedule
90838 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 |
|---|---|---|---|---|---|---|
| CaliforniaPhysician or licensed psychologist (incl. BCBA-D) · California Medi-Cal Specialty Mental Health Services (DHCS fee schedule for county Mental Health Plans) | $1,070.36⚠ over 3× mediansince 2026-07-01 | hour | $1,070.36 | Paid by the state, outside plans | — | Medi-Cal Behavioral Health Fee Schedules |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $209.65since 2025-01-01 | hour | $209.65 | Plans must pay at least this | — | Fee Schedule for Behavioral Health Provi |
| MontanaPhysician or licensed psychologist (incl. BCBA-D) · Montana Medicaid and HMK Plus (fee-for-service) | $192.03since 2026-07-01 | hour | $192.03 | Not classified | — | Montana Healthcare Programs fee schedule |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $176.64since 2024-07-01 | hour | $176.64 | Plans negotiate; applies out of network | — | OHP FFS behavioral health fee schedule ( |
| AlabamaPhysician or licensed psychologist (incl. BCBA-D) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $173.42since 2026-09-24 | hour | $173.42 | Not classified | — | Teaching Facility Fee Schedule |
| NebraskaPhysician or licensed psychologist (incl. BCBA-D) · Nebraska Medicaid (fee-for-service) | $159.88since 2026-07-01 | hour | $159.88 | Plans negotiate; applies out of network | — | Nebraska Medicaid Mental Health and Subs |
| ArkansasPhysician or licensed psychologist (incl. BCBA-D) · Arkansas Medicaid (fee-for-service) | $152.11since 2025-06-13 | hour | $152.11 | Not classified | — | Arkansas Medicaid Physician / CRNA / Fam |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $143.36since 2026-07-01 | hour | $143.36 | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| MarylandPhysician or licensed psychologist (incl. BCBA-D) · Maryland Public Behavioral Health System (specialty mental health, SUD and ABA, paid fee-for-service through the Carelon ASO) | $141.31since 2025-07-01 | hour | $141.31 | Paid by the state, outside plans | — | FY2026 PBHS Fee Schedule – Individual Pr |
| DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP) | $133.52since 2026-01-01 | hour | $133.52 | Plans negotiate; applies out of network | — | DMAP 2026 Physician Fee Schedule |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $130.82since 2022-01-01 | hour | $130.82 | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Mntl Hlt |
| New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service) | $126.91since 2025-10-01 | hour | $126.91 | Plans negotiate; applies out of network | — | eMedNY Physician Fee Schedule Sect 2 (Me |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $124.86since 2024-07-01 | hour | $124.86 | Not classified | — | CMAP fee schedule: Clinic and Outpatient |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $123.36since 2026-07-01 | hour | $123.36 | Plans must pay at least this | — | SoonerCare Title XIX Fee Schedule |
| VirginiaPhysician or licensed psychologist (incl. BCBA-D) · Virginia Medicaid behavioral health services (DMAS fee-for-service rates: community mental health, ARTS, ABA, BH redesign) | $118.04since 2024-01-01 | hour | $118.04 | Not classified | — | DMAS Medicaid bulletin: Behavioral Healt |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $117.37since 2026-07-01 | hour | $117.37 | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, Septembe |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $117.24since 2024-01-01 | hour | $117.24 | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $113.98since 2026-01-01 | hour | $113.98 | Not classified | — | Vermont Medicaid Fee Schedule - CPT Code |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $113.64since 2026-07-01 | hour | $113.64 | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $113.53since 2026-10-01 | hour | $113.53 | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| MinnesotaPhysician or licensed psychologist (incl. BCBA-D) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $111.73since 2026-05-21 | 60 min | — | Plans must pay at least this | — | MH Procedure CPT or HCPC Codes and Rates |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service | $109.94since 2026-06-01 | hour | $109.94 | Plans must pay at least this | — | Medicaid Fee-For-Service (FFS) Fee Sched |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $105.88since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| KentuckyPhysician or licensed psychologist (incl. BCBA-D) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $105.57since 2020-01-01 | hour | — | Plans negotiate; applies out of network | — | DMS CMHC Mental Health Substance Abuse f |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $104.98since 2024-01-01 | encounter | — | Plans expected to pay at least this | 79% | ODM Behavioral Health Coding Workbook (1 |
| ColoradoAny qualified provider (rate does not vary by provider) · Colorado behavioral health services paid fee-for-service by HCPF (outside the RAE capitation) | $103.30since 2026-07-01 | hour | $103.30 | Paid by the state, outside plans | — | Behavioral Health Fee-for-Service Rates |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $99.94since 2026-07-01 | hour | $99.94 | Plans negotiate; applies out of network | — | HCA Mental health and psychology service |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $95.66since 2026-01-01 | hour | $95.66 | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $95.31since 2017-01-01 | hour | $95.31 | Plans must pay at least this | — | Provider Type 26 Psychologist Reimbursem |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $94.87since 2026-03-01 | hour | $94.87 | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $87.12since 2026-01-01 | hour | $87.12 | Plans negotiate; applies out of network | — | MDHHS Child and Adolescent Health Center |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $85.72since 2026-01-01 | hour | $85.72 | Plans negotiate; applies out of network | — | Practitioner Fee Schedule (2026-01-01) |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $79.50since 2025-07-01 | hour | $79.50 | Plans must pay at least this | — | Specialized Behavioral Health Services f |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $75.80since 2024-08-01 | hour | $75.80 | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $74.95since 2024-01-01 | hour | $74.95 | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $73.78since 2024-04-01 | hour | $73.78 | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $65.52since 2024-07-01 | hour | $65.52 | Plans negotiate; applies out of network | — | SCDHHS Nurse Midwives Fee Schedule (sche |
| North CarolinaPhysician or licensed psychologist (incl. BCBA-D) · North Carolina Medicaid Direct (fee-for-service) | $63.54since 2025-10-01 | hour | $63.54 | Plans must pay at least this | — | NC Medicaid fee schedule 'Physician Assi |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $43.21since 2025-01-01 | hour | $43.21 | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid behavioral health programs (CMHC, ACT, BH Link, peer, SUD, health homes; fee-for-service) | $0.01since 2016-01-01 | hour | $0.01 | Plans negotiate; applies out of network | — | RI Medicaid Interactive Fee For Service |
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 90838?
It depends on the state. Of the 40 states with a published fee-for-service rate, the median is $112.63. California pays the most ($1,070.36 per hour) and Rhode Island the least ($0.01 per hour).
Which state pays the highest Medicaid rate for 90838?
California, at $1,070.36 per hour ($1,070.36 per hour), effective 2026-07-01.
How do Medicaid rates for 90838 compare with Medicare?
Where the billing units match, Medicaid pays between 79% and 79% of the 2026 Medicare physician fee schedule amount for the state (non-facility).
Do managed-care plans pay the same rate for 90838?
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
90791Mental health assessment (non-physician) · 45 states90832Outpatient psychotherapy and diagnostic evaluation · 45 states90834Outpatient psychotherapy and diagnostic evaluation · 45 states90837Outpatient psychotherapy and diagnostic evaluation · 45 states90847Outpatient psychotherapy and diagnostic evaluation · 45 states90853Outpatient psychotherapy and diagnostic evaluation · 45 states96130Mental health assessment (non-physician) · 45 states96131Mental health assessment (non-physician) · 45 states96136Mental health assessment (non-physician) · 45 states96137Mental health assessment (non-physician) · 45 states99202New-patient office visit, level 1 of 4 · 45 states99203New-patient office visit, level 2 of 4 · 45 states
Track 90838 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.