90853 Medicaid reimbursement rates by state
Outpatient psychotherapy and diagnostic evaluation. 22 state Medicaid programs publish a fee-for-service rate for 90853 at the physician psychologist level. Rates run from $3.50 in Pennsylvania to $152.94 in California, with a median of $26.89.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 22
- Median rate
- $26.89units vary by state
- Highest
- $152.94California
- Medicare (non-facility)
- $29.33–$36.102026 physician fee schedule
90853 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) | $152.94⚠ over 3× mediansince 2026-07-01 | — | — | Paid by the state, outside plans | — | Medi-Cal Behavioral Health Fee Schedules |
| MassachusettsPhysician or licensed psychologist (incl. BCBA-D) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $42.72since 2025-09-01 | — | — | Plans must pay at least this | — | Rates for Mental Health Services Provide |
| NebraskaPhysician or licensed psychologist (incl. BCBA-D) · Nebraska Medicaid (fee-for-service) | $42.02since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid Mental Health and Subs |
| WisconsinBehavior analyst (BCBA / licensed behavior analyst) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $40.64since 2023-02-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Mntl Hlt |
| OhioAgency provider · Ohio Medicaid (fee-for-service) | $37.31since 2024-01-01 | encounter | — | Plans expected to pay at least this | 125% | OAC 5160-27-03 Appendix A, Community Beh |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $33.70since 2010-02-01 | — | — | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Problem Gambling Fund (state-funded gambling treatment, claims through the Carelon ASO) | $31.94since 2021-11-01 | — | — | Not classified | — | FY2022 PBHS Fee Schedule – Mental Health |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $30.52since 2024-07-01 | — | — | Plans must pay at least this | — | NJMMIS Procedure Master Listing CPTHCPCS |
| VirginiaPhysician or licensed psychologist (incl. BCBA-D) · Virginia Medicaid behavioral health services (DMAS fee-for-service rates: community mental health, ARTS, ABA, BH redesign) | $30.27since 2024-01-01 | — | — | Not classified | — | DMAS Medicaid bulletin: Behavioral Healt |
| New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service) | $27.76since 2025-07-01 | unit | — | Plans negotiate; applies out of network | — | eMedNY Clinical Psychology Procedure Cod |
| MissouriPhysician or licensed psychologist (incl. BCBA-D) · Missouri MO HealthNet (fee-for-service) | $27.11since 2022-07-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Behavioral He |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $26.67since 2017-01-01 | — | — | Plans negotiate; applies out of network | — | OutPatient Max Allowed Site of Service F |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $25.34since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $24.95since 2026-05-21 | Session | — | Plans must pay at least this | — | MH Procedure CPT or HCPC Codes and Rates |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $23.91since 2025-10-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Nurse Practiti |
| ColoradoAny qualified provider (rate does not vary by provider) · Colorado behavioral health services paid fee-for-service by HCPF (outside the RAE capitation) | $23.77since 2026-07-01 | — | — | 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 | $20.10since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Mental health and psychology service |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $20.05since 2026-03-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $18.96since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Practitioner Fee Schedule (2026-01-01) |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $18.75since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Child and Adolescent Health Center |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Money Follows the Person (Family Supports track) | $4.81since 2008-01-01 | 15 min | $19.24 | Paid by the state, outside plans | — | IHCP Professional Fee Schedule (Last Upd |
| PennsylvaniaPhysician or licensed psychologist (incl. BCBA-D) · Pennsylvania Medical Assistance (fee-for-service) | $3.50since 2022-07-01 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
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 90853?
It depends on the state. Of the 22 states with a published fee-for-service rate, the median is $26.89. California pays the most ($152.94) and Pennsylvania the least ($3.50).
Which state pays the highest Medicaid rate for 90853?
California, at $152.94, effective 2026-07-01.
How do Medicaid rates for 90853 compare with Medicare?
Where the billing units match, Medicaid pays between 125% and 125% of the 2026 Medicare physician fee schedule amount for the state (non-facility).
Do managed-care plans pay the same rate for 90853?
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 90853 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.