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S8265 Medicaid reimbursement rates by state

Haberman feeder for cleft lip/palate. 15 state Medicaid programs publish a fee-for-service rate for S8265 at the physician psychologist level. Rates run from $2.17 in Maryland to $42.90 in Washington, with a median of $19.28.

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

States publishing
15
Median rate
$19.28units vary by state
Highest
$42.90Washington
Medicare (non-facility)
—not on the physician fee schedule

S8265 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
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$42.90since 2021-01-01——Plans negotiate; applies out of network—HCA Medical equipment and supplies fee s
AlaskaAny qualified provider (rate does not vary by provider) · Alaska Medicaid (fee-for-service, Department of Health)$28.50since 2025-10-01——Not classified—Alaska Medicaid DMEPOS Interim Fee Sched
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$28.11since 2025-10-01——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Durable Medica
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$22.00since 2003-01-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$19.80since 2025-09-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$19.32since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$19.32since 2002-04-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$19.28since 2025-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$19.27since 2026-10-01——Plans negotiate; applies out of network—AHCCCS Arizona Health Care Cost Containm
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$19.24since 2018-01-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Supplies
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$18.74since 2023-03-01——Not classified—Vermont Medicaid Fee Schedule - DME Code
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$18.52since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$14.29since 2012-07-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$12.68since 2023-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$2.17since 2013-07-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth

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 S8265?

It depends on the state. Of the 15 states with a published fee-for-service rate, the median is $19.28. Washington pays the most ($42.90) and Maryland the least ($2.17).

Which state pays the highest Medicaid rate for S8265?

Washington, at $42.90, effective 2021-01-01.

Do managed-care plans pay the same rate for S8265?

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 Equipment & supplies codes

Track S8265 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
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