96136 Medicaid reimbursement rates by state
Mental health assessment (non-physician). 22 state Medicaid programs publish a fee-for-service rate for 96136 at the physician psychologist level. Rates run from $11.31 in New Jersey to $412.94 in California, with a median of $31.35.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 22
- Median rate
- $31.35units vary by state
- Highest
- $412.94California
- Medicare (non-facility)
- $40.33–$56.392026 physician fee schedule
96136 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) | $412.94⚠ over 3× mediansince 2026-07-01 | 30 min | $825.88 | Paid by the state, outside plans | 732–895% | Medi-Cal Behavioral Health Fee Schedules |
| NebraskaPhysician or licensed psychologist (incl. BCBA-D) · Nebraska Medicaid (fee-for-service) | $135.41⚠ over 3× mediansince 2026-07-01 | 30 min | $270.82 | Plans negotiate; applies out of network | 327% | Nebraska Medicaid Mental Health and Subs |
| 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) | $73.96since 2024-07-01 | 30 min | $147.92 | Paid by the state, outside plans | 161–167% | FY2025 PBHS Fee Schedule – Individual Pr |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $66.74since 2026-07-01 | 30 min | $133.48 | Plans negotiate; applies out of network | 147% | Child Health Plan Plus Behavioral Health |
| MassachusettsPhysician or licensed psychologist (incl. BCBA-D) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $55.30since 2025-09-01 | 30 min | $110.60 | Plans must pay at least this | — | Rates for Mental Health Services Provide |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $52.97since 2022-01-01 | 30 min | $105.94 | Plans negotiate; applies out of network | 125% | ForwardHealth max fee schedule: Medical- |
| MissouriPhysician or licensed psychologist (incl. BCBA-D) · Missouri MO HealthNet (fee-for-service) | $44.24since 2022-07-01 | 30 min | $88.48 | Plans must pay at least this | 104–110% | MO HealthNet fee schedule: Behavioral He |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $40.59since 2019-01-01 | 30 min | $81.18 | Plans negotiate; applies out of network | 92–98% | Schedule of Maximum Allw Pymt Physician |
| New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service) | $37.22since 2023-10-01 | 30 min | $74.44 | Plans negotiate; applies out of network | 74–88% | eMedNY Clinical Psychology Procedure Cod |
| MinnesotaPhysician or licensed psychologist (incl. BCBA-D) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $36.32since 2026-05-21 | 30 min | $72.64 | Plans must pay at least this | 83% | MH Procedure CPT or HCPC Codes and Rates |
| OhioAgency provider · Ohio Medicaid (fee-for-service) | $34.79since 2024-01-01 | 30 min | $69.58 | Plans expected to pay at least this | 84% | OAC 5160-27-03 Appendix A, Community Beh |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $27.90since 2026-01-01 | 30 min | $55.80 | Plans negotiate; applies out of network | 64–67% | MDHHS Child and Adolescent Health Center |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $27.15since 2019-05-15 | 30 min | $54.30 | Plans negotiate; applies out of network | 60–65% | HFS Licensed Clinical Psychologists and |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $26.75since 2026-07-01 | 30 min | $53.50 | Plans negotiate; applies out of network | 53–59% | HCA Mental health and psychology service |
| ArizonaPhysician or licensed psychologist (incl. BCBA-D) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $26.24since 2026-10-01 | 30 min | $52.48 | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $21.85since 2026-07-01 | 30 min | $43.70 | Plans negotiate; applies out of network | 51% | DMAS procedure fee file cptmedical4.csv |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $21.84since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $21.16since 2020-03-10 | 30 min | $42.32 | Plans must pay at least this | 51% | NC Medicaid fee schedule 'Local Health D |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $19.96since 2020-12-21 | 30 min | $39.92 | Plans negotiate; applies out of network | 44–48% | PA DHS PROMISe Outpatient Fee Schedule ( |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $19.65since 2025-09-01 | 30 min | $39.30 | Plans negotiate; applies out of network | 44–47% | TMHP Texas Medicaid Fee Schedule - Physi |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $16.63since 2026-01-01 | 30 min | $33.26 | Plans negotiate; applies out of network | 36–39% | Practitioner Fee Schedule (2026-01-01) |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $11.31since 2024-06-01 | 30 min | $22.62 | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
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 96136?
It depends on the state. Of the 22 states with a published fee-for-service rate, the median is $31.35. California pays the most ($412.94 per 30 min) and New Jersey the least ($11.31 per 30 min).
Which state pays the highest Medicaid rate for 96136?
California, at $412.94 per 30 min ($825.88 per hour), effective 2026-07-01.
How do Medicaid rates for 96136 compare with Medicare?
Where the billing units match, Medicaid pays between 38% and 814% of the 2026 Medicare physician fee schedule amount for the state (non-facility).
Do managed-care plans pay the same rate for 96136?
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 96136 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.