99235 Medicaid reimbursement rates by state
Mental health assessment (non-physician). 45 state Medicaid programs publish a fee-for-service rate for 99235 at the physician psychologist level. Rates run from $30.30 in New York to $1,369.52 in California, with a median of $123.55.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 45
- Median rate
- $123.55units vary by state
- Highest
- $1,369.52California
- Medicare (non-facility)
- —not on the physician fee schedule
99235 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) | $1,369.52⚠ over 3× mediansince 2026-07-01 | — | — | Paid by the state, outside plans | — | Medi-Cal Behavioral Health Fee Schedules |
| AlabamaPhysician or licensed psychologist (incl. BCBA-D) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $263.19since 2026-09-24 | — | — | Not classified | — | Teaching Facility Fee Schedule |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $228.70since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service CPT |
| MontanaPhysician or licensed psychologist (incl. BCBA-D) · Montana Medicaid and HMK Plus (fee-for-service) | $200.95since 2026-07-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $186.53since 2021-01-01 | — | — | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| GeorgiaPhysician or licensed psychologist (incl. BCBA-D) · Georgia Medicaid (fee-for-service) | $167.85since 2020-08-14 | — | — | Plans negotiate; applies out of network | — | Max Allow Pymt Physician Enhanced Rate C |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $162.56since 2026-01-01 | — | — | Plans must pay at least this | — | Maryland Medicaid Professional Services |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $157.92since 2016-01-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service | $155.24since 2026-06-01 | — | — | Plans must pay at least this | — | Medicaid Fee-For-Service (FFS) Fee Sched |
| North CarolinaPhysician or licensed psychologist (incl. BCBA-D) · North Carolina Medicaid Direct (fee-for-service) | $149.97since 2025-10-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'ACA Physician |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $148.52since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $145.55since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $143.04since 2021-11-17 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $142.60since 2020-01-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP) | $139.49since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | DMAP 2026 Physician Fee Schedule |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $135.67since 2020-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Physician fee schedule (2020 |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $135.64since 2022-07-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Nurse Midwife |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $134.32since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $129.46since 2026-07-01 | — | — | Plans must pay at least this | — | SoonerCare Title XIX Fee Schedule |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $128.53since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $124.99since 2026-01-01 | — | — | Not classified | — | CMAP fee schedule: Physician Office and |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $124.85since 2023-06-01 | — | — | Plans negotiate; applies out of network | — | 53 Pa.B. 2906 Medical Assistance Program |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $123.55since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $123.40since 2026-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, Septembe |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $117.89since 2026-07-01 | — | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $117.54since 2026-01-01 | — | — | Not classified | — | Vermont Medicaid Fee Schedule - CPT Code |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $117.14since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Emergency Adoption (date filed: Septembe |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $116.92since 2024-07-01 | — | — | Not classified | — | SCDHHS Base Physician Fee Schedule (sche |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $115.51since 2024-08-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $113.55since 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) | $111.18since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Practitioner Fee Schedule (2026-01-01) |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $109.15since 2015-07-01 | — | — | Plans must pay at least this | — | Provider Type 77 Physician's Assistant R |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $108.10since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $107.99since 2024-04-01 | — | — | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $103.60since 2025-07-01 | — | — | Plans must pay at least this | — | Specialized Behavioral Health Services f |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $103.21since 2026-04-01 | — | — | Plans negotiate; applies out of network | — | BMS RBRVS 2026 Effective 4/1/26 - 3/31/2 |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $103.00since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file cptmedical4.csv |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $99.69since 2026-01-01 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $99.09since 2025-07-01 | — | — | Plans must pay at least this | — | NJMMIS Procedure Master Listing CPTHCPCS |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $98.18since 2026-07-01 | — | — | Plans must pay at least this | — | HCA Enhanced adult primary care fee sche |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $92.86since 2025-05-15 | — | — | Not classified | — | Arkansas Medicaid Oral Surgeon Fee Sched |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $91.16since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Vision Fee Schedule database, Janu |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $84.32since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | Appendix DD to OAC 5160-1-60 (Non-Instit |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service) | $71.08since 2000-12-01 | — | — | Plans negotiate; applies out of network | — | RI Medicaid Interactive Fee For Service |
| New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid HIV Enhanced Fees for Physicians Program | $30.30since 2022-04-01 | unit | — | Not classified | — | eMedNY Physician Enhanced Program Fee Sc |
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 99235?
It depends on the state. Of the 45 states with a published fee-for-service rate, the median is $123.55. California pays the most ($1,369.52) and New York the least ($30.30 per unit).
Which state pays the highest Medicaid rate for 99235?
California, at $1,369.52, effective 2026-07-01.
Do managed-care plans pay the same rate for 99235?
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) · 45 states90832Outpatient psychotherapy and diagnostic evaluation · 45 states90834Outpatient psychotherapy and diagnostic evaluation · 45 states90837Outpatient psychotherapy and diagnostic evaluation · 45 states90847Outpatient psychotherapy and diagnostic evaluation · 45 states90853Outpatient psychotherapy and diagnostic evaluation · 45 states96130Mental health assessment (non-physician) · 45 states96131Mental health assessment (non-physician) · 45 states96136Mental health assessment (non-physician) · 45 states96137Mental health assessment (non-physician) · 45 states99202New-patient office visit, level 1 of 4 · 45 states99203New-patient office visit, level 2 of 4 · 45 states
Track 99235 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.