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92025 Medicaid reimbursement rates by state

Eye exams and vision services. 34 state Medicaid programs publish a fee-for-service rate for 92025 at the physician psychologist level. Rates run from $9.30 in New Jersey to $38.24 in Arizona, with a median of $15.79.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
34
Median rate
$15.79units vary by state
Highest
$38.24Arizona
Medicare (non-facility)
$33.22–$49.092026 physician fee schedule

92025 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.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$38.24since 2026-10-01——Plans negotiate; applies out of network—AHCCCS Arizona Health Care Cost Containm
AlabamaPhysician or licensed psychologist (incl. BCBA-D) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$31.49since 2026-09-24——Not classified—Teaching Facility Fee Schedule
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$28.56since 2026-02-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$27.13since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service CPT
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$26.82since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$23.07since 2024-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
ArkansasPhysician or licensed psychologist (incl. BCBA-D) · Arkansas Medicaid (fee-for-service)$22.76since 2025-06-13——Not classified—Arkansas Medicaid Physician / CRNA / Fam
PennsylvaniaPhysician or licensed psychologist (incl. BCBA-D) · Pennsylvania Medical Assistance (fee-for-service)$18.44since 2009-05-27——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$17.74since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$17.41since 2026-01-01——Plans must pay at least this—Louisiana Medicaid Enhanced Professional
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$17.30since 2026-07-01——Plans must pay at least this—SoonerCare Title XIX Fee Schedule
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$16.87since 2024-01-01——Plans must pay at least this—Provider Type 20 Physician, MD., Osteopa
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$16.78since 2026-07-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical4.csv
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$16.45since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$16.32since 2023-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, May 2026
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$16.00since 2016-01-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$15.88since 2018-09-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$15.69since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$15.43since 2024-07-01——Not classified—SCDHHS Pediatric Subspecialty and Neonat
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$15.38since 2026-01-01——Not classified—Maryland Medicaid Professional Services
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$15.34since 2026-02-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$15.06since 2026-01-01——Plans negotiate; applies out of network—Practitioner Fee Schedule (2026-01-01)
New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service)$14.60since 2025-10-01unit—Plans negotiate; applies out of network—eMedNY Physician Fee Schedule Sect 2 (Me
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$14.54since 2024-08-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$14.41since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Nurse Practiti
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$14.39since 2026-10-01——Plans negotiate; applies out of network—Emergency Adoption (date filed: Septembe
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$14.38since 2022-07-01——Plans must pay at least this—MO HealthNet fee schedule: Radiology - P
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$14.03since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$13.37since 2020-01-01——Plans negotiate; applies out of network—KY Medicaid Physician fee schedule (2020
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$12.51since 2024-01-01——Plans negotiate; applies out of network—Appendix DD to OAC 5160-1-60 (Non-Instit
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$12.35since 2026-01-01——Plans negotiate; applies out of network—MDHHS Vision Fee Schedule database, Janu
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$11.66since 2026-07-01——Plans negotiate; applies out of network—HCA Physician-related services fee sched
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$11.62since 2026-01-01——Not classified—CMAP fee schedule: Physician Office and
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$9.30since 2014-07-01base unit—Not classified—NJMMIS Procedure Master Listing CPTCodes

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 92025?

It depends on the state. Of the 34 states with a published fee-for-service rate, the median is $15.79. Arizona pays the most ($38.24) and New Jersey the least ($9.30 per base unit).

Which state pays the highest Medicaid rate for 92025?

Arizona, at $38.24, effective 2026-10-01.

Do managed-care plans pay the same rate for 92025?

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 Vision & hearing codes

92060Eye exams and vision services · 35 states92083Eye exams and vision services · 35 states92235Eye exams and vision services · 35 states92240Eye exams and vision services · 34 states92242Eye exams and vision services · 34 states92265Eye exams and vision services · 34 statesV2624Polishing/resurfacing of ocular prosthesis · 32 statesV2625Enlargement of ocular prosthesis · 31 states92609Therapy using a communication device · 30 statesV2626Reduction of ocular prosthesis · 30 statesV2628Fabrication and fitting of ocular conformer · 30 statesV2627Scleral cover shell · 29 states
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Medicaid rates by state
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