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96139 Medicaid reimbursement rates by state

Mental health assessment (non-physician). 28 state Medicaid programs publish a fee-for-service rate for 96139 at the physician psychologist level. Rates run from $15.50 in New Jersey to $150.70 in California, with a median of $31.09.

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

States publishing
28
Median rate
$31.09units vary by state
Highest
$150.70California
Medicare (non-facility)
$30.52–$51.052026 physician fee schedule

96139 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
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal Specialty Mental Health Services (DHCS fee schedule for county Mental Health Plans)$150.70⚠ over 3× mediansince 2026-07-0130 min$301.40Paid by the state, outside plans295–388%Medi-Cal Behavioral Health Fee Schedules
NebraskaPhysician or licensed psychologist (incl. BCBA-D) · Nebraska Medicaid (fee-for-service)$63.19since 2026-07-0130 min$126.38Plans negotiate; applies out of network193%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)$61.59since 2024-07-0130 min$123.18Paid by the state, outside plans162–172%FY2025 PBHS Fee Schedule – Individual Pr
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$47.40since 2025-01-0130 min$94.80Plans must pay at least this146%Fee Schedule for Behavioral Health Provi
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$42.58since 2022-01-0130 min$85.16Plans negotiate; applies out of network126%ForwardHealth max fee schedule: Medical-
MassachusettsPhysician or licensed psychologist (incl. BCBA-D) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$41.53since 2025-09-0130 min$83.06Plans must pay at least this—Rates for Mental Health Services Provide
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$36.19since 2026-07-0130 min$72.38Plans negotiate; applies out of network104%DMAS procedure fee file cptmedical4.csv
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$35.76since 2026-10-0130 min$71.52Plans negotiate; applies out of network104%AHCCCS Arizona Health Care Cost Containm
MissouriPhysician or licensed psychologist (incl. BCBA-D) · Missouri MO HealthNet (fee-for-service)$35.10since 2022-07-0130 min$70.20Plans must pay at least this104–115%MO HealthNet fee schedule: Behavioral He
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$33.41since 2019-01-0130 min$66.82Plans must pay at least this94%Provider Type 26 Psychologist Reimbursem
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$32.88since 2019-07-0130 min$65.76Plans negotiate; applies out of network91–104%Schedule of Maximum Allw Pymt Physician
New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service)$31.97since 2023-10-0130 min$63.94Plans negotiate; applies out of network76–95%eMedNY Physician Fee Schedule Sect 2 (Me
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$31.33since 2024-08-0130 min$62.66Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$31.09since 2025-10-0130 min$62.18Plans must pay at least this94%NC Medicaid fee schedule 'Nurse Practiti
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$31.09since 2019-01-0130 min$62.18Plans must pay at least this—ODMHSAS PICIS 'Rates and Codes for Agenc
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$30.88since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$30.76since 2019-01-0130 min$61.52Plans must pay at least this95%Iowa Medicaid fee schedule #02 PHYSICIAN
MinnesotaPhysician or licensed psychologist (incl. BCBA-D) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$30.22since 2026-05-2130 min$60.44Plans must pay at least this83%MH Procedure CPT or HCPC Codes and Rates
South CarolinaPhysician or licensed psychologist (incl. BCBA-D) · South Carolina Healthy Connections Medicaid (fee-for-service)$29.68since 2025-12-0130 min$59.36Not classified—SCDHHS RBHS Substance Use Services Fee S
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$28.66since 2026-01-0130 min$57.32Not classified75%CMAP fee schedule: Physician Office and
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$27.99since 2026-01-0130 min$55.98Plans negotiate; applies out of network71–79%OHA Administrative Examinations and Repo
AlabamaPhysician or licensed psychologist (incl. BCBA-D) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$25.88since 2025-12-0130 min$51.76Not classified84%Behavior Health Services Fee Schedule
KentuckyPhysician or licensed psychologist (incl. BCBA-D) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$23.61since 2026-04-0130 min$47.22Plans negotiate; applies out of network75%KY Medicaid Behavioral Health fee schedu
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$22.58since 2026-01-0130 min$45.16Plans negotiate; applies out of network66–70%MDHHS Child and Adolescent Health Center
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$22.36since 2026-07-0130 min$44.72Plans negotiate; applies out of network51–60%HCA Mental health and psychology service
LouisianaPhysician or licensed psychologist (incl. BCBA-D) · Louisiana Medicaid (fee-for-service)$21.16since 2025-07-0130 min$42.32Plans must pay at least this—Specialized Behavioral Health Services f
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$18.87since 2026-07-0130 min$37.74Plans negotiate; applies out of network50%Child Health Plan Plus Behavioral Health
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$15.50since 2024-06-0130 min$31.00Not classified38–40%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 96139?

It depends on the state. Of the 28 states with a published fee-for-service rate, the median is $31.09. California pays the most ($150.70 per 30 min) and New Jersey the least ($15.50 per 30 min).

Which state pays the highest Medicaid rate for 96139?

California, at $150.70 per 30 min ($301.40 per hour), effective 2026-07-01.

How do Medicaid rates for 96139 compare with Medicare?

Where the billing units match, Medicaid pays between 39% and 342% of the 2026 Medicare physician fee schedule amount for the state (non-facility).

Do managed-care plans pay the same rate for 96139?

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

Track 96139 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
Medicaid rates by state