96170 Medicaid reimbursement rates by state
Behavioral health services (fee schedule). 20 state Medicaid programs publish a fee-for-service rate for 96170 at the physician psychologist level. Rates run from $22.58 in Ohio to $420.67 in California, with a median of $58.19.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 20
- Median rate
- $58.19units vary by state
- Highest
- $420.67California
- Medicare (non-facility)
- —not on the physician fee schedule
96170 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 Drug Medi-Cal Organized Delivery System (DHCS county fee schedule / interim rates) | $420.67⚠ over 3× mediansince 2026-07-01 | 30 min | $841.34 | Paid by the state, outside plans | — | Medi-Cal Behavioral Health Fee Schedules |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $75.83since 2022-01-01 | 30 min | $151.66 | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Mntl Hlt |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $70.65since 2026-02-09 | 30 min | $141.30 | Plans must pay at least this | — | Provider Type 26 Psychologist Reimbursem |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $68.33since 2025-12-01 | 30 min | $136.66 | Plans must pay at least this | — | Iowa Medicaid fee schedule #29 PSYCHOLOG |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $67.37since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $65.62since 2026-10-01 | 30 min | $131.24 | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $64.42since 2020-01-01 | 30 min | $128.84 | Plans negotiate; applies out of network | — | KY Medicaid Physician fee schedule (2020 |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $60.91since 2025-09-01 | 30 min | $121.82 | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $60.24since 2026-01-01 | 30 min | $120.48 | Plans negotiate; applies out of network | — | OHP FFS behavioral health 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) | $59.78since 2026-07-01 | 30 min | $119.56 | Paid by the state, outside plans | — | Integrated Care Fee Schedule FY26-27 |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $56.60since 2026-02-01 | 30 min | $113.20 | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $55.27since 2026-07-01 | 30 min | $110.54 | Plans negotiate; applies out of network | — | DMAS procedure fee file cptmedical4.csv |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $54.79since 2026-07-01 | 30 min | $109.58 | Plans must pay at least this | — | HCA Physician-related services fee sched |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $54.26since 2026-10-01 | 30 min | $108.52 | Plans negotiate; applies out of network | — | Emergency Adoption (date filed: Septembe |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $52.16since 2026-01-01 | 30 min | $104.32 | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| OklahomaPhysician or licensed psychologist (incl. BCBA-D) · Oklahoma SoonerCare (fee-for-service, OHCA) | $37.60since 2022-07-01 | 30 min | $75.20 | Plans must pay at least this | — | ODMHSAS PICIS 'SoonerCare - Psychologist |
| LouisianaPhysician or licensed psychologist (incl. BCBA-D) · Louisiana Medicaid (fee-for-service) | $25.52since 2024-01-01 | 30 min | $51.04 | Plans must pay at least this | — | Specialized Behavioral Health Services f |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $25.34since 2026-01-01 | 30 min | $50.68 | 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) | $24.00since 2021-07-01 | 30 min | $48.00 | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid School Program (school-based services) | $22.58since 2020-01-01 | 30 min | $45.16 | Paid by the state, outside plans | — | ODM CPT/HCPCS procedure code changes for |
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 96170?
It depends on the state. Of the 20 states with a published fee-for-service rate, the median is $58.19. California pays the most ($420.67 per 30 min) and Ohio the least ($22.58 per 30 min).
Which state pays the highest Medicaid rate for 96170?
California, at $420.67 per 30 min ($841.34 per hour), effective 2026-07-01.
Do managed-care plans pay the same rate for 96170?
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
90791Mental health assessment (non-physician) · 39 states90832Outpatient psychotherapy and diagnostic evaluation · 39 states90834Outpatient psychotherapy and diagnostic evaluation · 39 states90837Outpatient psychotherapy and diagnostic evaluation · 39 states90847Outpatient psychotherapy and diagnostic evaluation · 39 states90853Outpatient psychotherapy and diagnostic evaluation · 39 states96110Mental health assessment (non-physician) · 39 states96112Mental health assessment (non-physician) · 39 states96130Mental health assessment (non-physician) · 39 states96131Mental health assessment (non-physician) · 39 states96136Mental health assessment (non-physician) · 39 states96137Mental health assessment (non-physician) · 39 states
Track 96170 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.