96158 Medicaid reimbursement rates by state
Positive behavioral interventions and support. 29 state Medicaid programs publish a fee-for-service rate for 96158 at the physician psychologist level. Rates run from $15.05 in Kansas to $885.12 in Kentucky, with a median of $51.79.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 29
- Median rate
- $51.79units vary by state
- Highest
- $885.12Kentucky
- Medicare (non-facility)
- $71.32–$87.732026 physician fee schedule
96158 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 |
|---|---|---|---|---|---|---|
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Supports for Community Living (SCL) 1915(c) waiver | $885.12since 2025-01-01 | Per Plan | — | Paid by the state, outside plans | — | DMS Home and Community Based Services Wa |
| AlabamaPhysician or licensed psychologist (incl. BCBA-D) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $107.39since 2026-09-24 | 30 min | $214.78 | Not classified | 150% | Teaching Facility Fee Schedule |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $97.03since 2025-01-01 | 30 min | $194.06 | Plans must pay at least this | 134% | New Mexico Medicaid Fee for Service CPT |
| MissouriPhysician or licensed psychologist (incl. BCBA-D) · Missouri MO HealthNet (fee-for-service) | $66.52since 2022-07-01 | 30 min | $133.04 | Plans must pay at least this | — | MO HealthNet fee schedule: Behavioral He |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $63.50since 2022-01-01 | 30 min | $127.00 | Plans negotiate; applies out of network | 87% | ForwardHealth max fee schedule: Mntl Hlt |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $61.80since 2026-10-01 | 30 min | $123.60 | Plans negotiate; applies out of network | 84% | AHCCCS Arizona Health Care Cost Containm |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $59.97since 2026-01-01 | 30 min | $119.94 | Plans negotiate; applies out of network | 78–81% | OHP FFS behavioral health fee schedule ( |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $58.32since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| PennsylvaniaPhysician or licensed psychologist (incl. BCBA-D) · Pennsylvania Medical Assistance (fee-for-service) | $58.00since 2024-09-09 | 30 min | $116.00 | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $57.92since 2020-01-01 | 30 min | $115.84 | Plans must pay at least this | 79% | Provider Type 26 Psychologist Reimbursem |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $57.63since 2026-10-01 | 30 min | $115.26 | Plans negotiate; applies out of network | 66–75% | Medi-Cal Rates (Rates files zip: rates_d |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $56.86since 2026-02-01 | 30 min | $113.72 | Plans negotiate; applies out of network | 77% | MHCP Fee Schedule - Current Fee Schedule |
| ColoradoAny qualified provider (rate does not vary by provider) · Colorado behavioral health services paid fee-for-service by HCPF (outside the RAE capitation) | $54.04since 2026-07-01 | 30 min | $108.08 | Paid by the state, outside plans | 72% | Integrated Care Fee Schedule FY26-27 |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $52.22since 2020-01-01 | 30 min | $104.44 | Plans negotiate; applies out of network | 70–73% | OutPatient Site of Service (in Zipped Fe |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $51.79since 2026-07-01 | 30 min | $103.58 | Plans negotiate; applies out of network | 71% | DMAS procedure fee file cptmedical4.csv |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $51.74since 2025-10-01 | 30 min | $103.48 | Plans must pay at least this | 71% | NC Medicaid fee schedule 'Local Health D |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $47.99since 2020-01-01 | 30 min | $95.98 | Plans negotiate; applies out of network | 64–66% | TMHP Texas Medicaid Fee Schedule - Physi |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $47.59since 2026-07-01 | 30 min | $95.18 | Plans must pay at least this | 59–63% | HCA Physician-related services fee sched |
| LouisianaPhysician or licensed psychologist (incl. BCBA-D) · Louisiana Medicaid (fee-for-service) | $44.27since 2025-07-01 | 30 min | $88.54 | Plans must pay at least this | — | Specialized Behavioral Health Services f |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $42.37since 2026-01-01 | 30 min | $84.74 | Plans negotiate; applies out of network | 58–59% | MDHHS Non-Physician Behavioral Health Fe |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $41.66since 2026-10-01 | 30 min | $83.32 | Plans negotiate; applies out of network | 52–55% | Emergency Adoption (date filed: Septembe |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $38.16since 2024-01-01 | 30 min | $76.32 | Plans must pay at least this | 53% | Iowa Medicaid fee schedule #02 PHYSICIAN |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $36.52since 2024-07-01 | 30 min | $73.04 | Plans negotiate; applies out of network | — | SCDHHS Nurse Midwives Fee Schedule (sche |
| 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) | $36.26since 2025-07-01 | 30 min | $72.52 | Paid by the state, outside plans | 48–49% | FY2026 PBHS Fee Schedule – Individual Pr |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $34.00since 2025-01-01 | 30 min | $68.00 | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| OklahomaPhysician or licensed psychologist (incl. BCBA-D) · Oklahoma SoonerCare (fee-for-service, OHCA) | $32.18since 2022-07-01 | 30 min | $64.36 | Plans must pay at least this | 45% | ODMHSAS PICIS 'SoonerCare - Psychologist |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $24.39since 2026-01-01 | 30 min | $48.78 | Not classified | 32% | CMAP fee schedule: Physician Office and |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid School Program (school-based services) | $21.21since 2020-01-01 | 30 min | $42.42 | Paid by the state, outside plans | 29% | ODM CPT/HCPCS procedure code changes for |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $15.05since 2020-01-01 | 30 min | $30.10 | Not classified | 21% | KMAP Fee Schedule QMB Medicaid (FeeSched |
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 96158?
It depends on the state. Of the 29 states with a published fee-for-service rate, the median is $51.79. Kentucky pays the most ($885.12 per Per Plan) and Kansas the least ($15.05 per 30 min).
Which state pays the highest Medicaid rate for 96158?
Kentucky, at $885.12 per Per Plan, effective 2025-01-01.
How do Medicaid rates for 96158 compare with Medicare?
Where the billing units match, Medicaid pays between 21% and 150% of the 2026 Medicare physician fee schedule amount for the state (non-facility).
Do managed-care plans pay the same rate for 96158?
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.
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Track 96158 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.