G0316 Medicaid reimbursement rates by state
Prolonged hospital inpatient or observation care evaluation.... 16 state Medicaid programs publish a fee-for-service rate for G0316 at the physician psychologist level. Rates run from $6.73 in Kansas to $266.79 in California, with a median of $25.88.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 16
- Median rate
- $25.88per 15 min
- Highest
- $266.79California
- Medicare (non-facility)
- $32.65–$41.812026 physician fee schedule
G0316 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) | $266.79⚠ over 3× mediansince 2026-07-01 | 15 min | $1,067.16 | Paid by the state, outside plans | — | Medi-Cal Behavioral Health Fee Schedules |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $48.83since 2026-07-01 | 15 min | $195.32 | Not classified | — | Montana Healthcare Programs fee schedule |
| North DakotaAny qualified provider (rate does not vary by provider) · North Dakota Medicaid (fee-for-service) | $37.92since 2026-07-01 | 15 min | $151.68 | Not classified | — | ND Medicaid Professional (General) Servi |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $30.43since 2025-01-01 | 15 min | $121.72 | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service | $30.12since 2026-06-01 | 15 min | $120.48 | Plans negotiate; applies out of network | — | Medicaid Fee-For-Service (FFS) Fee Sched |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $28.38since 2026-07-01 | 15 min | $113.52 | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $27.81since 2023-01-01 | 15 min | $111.24 | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $27.74since 2026-02-01 | 15 min | $110.96 | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| District of ColumbiaAny qualified provider (rate does not vary by provider) · DC Medicaid (DHCF) fee-for-service | $24.02since 2026-01-01 | 15 min | $96.08 | Not classified | — | REFRP00178CSV - Medical Fee Schedule Rep |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $23.96since 2026-01-01 | 15 min | $95.84 | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $23.75since 2023-01-01 | 15 min | $95.00 | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $23.57since 2023-01-01 | 15 min | $94.28 | Plans must pay at least this | — | MO HealthNet fee schedule: Practitioner |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $23.29since 2023-01-01 | 15 min | $93.16 | Plans negotiate; applies out of network | — | Appendix DD to OAC 5160-1-60 (Non-Instit |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $20.64since 2026-07-01 | 15 min | $82.56 | Plans negotiate; applies out of network | — | HCA Physician-related services fee sched |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $13.88since 2026-07-01 | 15 min | $55.52 | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $6.73since 2023-01-01 | 15 min | $26.92 | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
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 G0316?
It depends on the state. Of the 16 states with a published fee-for-service rate, the median is $25.88 per 15 min. California pays the most ($266.79 per 15 min) and Kansas the least ($6.73 per 15 min).
Which state pays the highest Medicaid rate for G0316?
California, at $266.79 per 15 min ($1,067.16 per hour), effective 2026-07-01.
Do managed-care plans pay the same rate for G0316?
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.