The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 90865. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
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Publishing states
25
Median % of Medicare
76.3%
Rate range
$71.17 - $230.82
90865 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $116.00 | 68% | -- | 2026 |
| California | $135.19 | 79.2% | -- | 2026 |
| Connecticut | $95.14 | 55.7% | Required | 2026 |
| District of Columbia | $151.21 | 88.6% | Not required | 2026 |
| Iowa | $114.58 | 67.1% | -- | 2024 |
| Idaho | $140.54 | 82.3% | Not required | 2026 |
| Illinois | $80.97 | 47.4% | -- | 2024 |
| Kansas | $127.01 | 74.4% | -- | 2024 |
| Kentucky | $96.43 | 56.5% | -- | 2026 |
| Massachusetts | $122.02 | 71.5% | -- | 2026 |
| Maine | $118.24 | 69.3% | -- | 2026 |
| Missouri | $166.51 | 97.6% | Not required | 2022 |
| Montana | $218.29 | 127.9% | -- | 2026 |
| North Carolina | $125.40 | 73.5% | -- | 2025 |
| North Dakota | $188.87 | 110.7% | Not required | 2026 |
| New Hampshire | $71.17 | 41.7% | Not required | 2026 |
| New Mexico | $230.82 | 135.2% | -- | 2025 |
| Oklahoma | $151.75 | 88.9% | -- | 2026 |
| Oregon | $137.92* | 80.8% | -- | 2026 |
| Rhode Island | $158.41 | -- | -- | 2026 |
| Utah | $130.27* | 76.3% | Required | 2026 |
| Virginia | $174.48 | 102.2% | -- | 2026 |
| Washington | $102.62 | 60.1% | -- | 2026 |
| Wisconsin | $148.62 | 87.1% | -- | 2022 |
| West Virginia | $117.85 | 69.1% | -- | 2026 |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * are representative published variants or methodology-derived rates. "--" in the prior-auth column means the state publishes no PA flag.
Related behavioral health codes
- 90785 - Psychotherapy interactive complexity (add-on)
- 90791 - Psychiatric diagnostic evaluation, no medical services
- 90792 - Psychiatric diagnostic evaluation with medical services
- 90832 - Psychotherapy, 30 minutes
- 90833 - Psychotherapy, 30 minutes, added to an E&M visit
- 90834 - Psychotherapy, 45 minutes
- 90836 - Psychotherapy, 45 minutes, added to an E&M visit
- 90837 - Psychotherapy, 60 minutes
Frequently asked questions
How much does Medicaid pay for 90865?
25 state Medicaid programs publish a fee-for-service rate for 90865 (narcosynthesis (drug-assisted psychiatric interview)), ranging from $71.17 in New Hampshire to $230.82 in New Mexico, with a median of 76.3% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for 90865?
New Mexico publishes the highest Medicaid rate for 90865 at $230.82 (135.2% of the national Medicare amount). New Hampshire publishes the lowest at $71.17.
Does 90865 require prior authorization under Medicaid?
2 of the 25 publishing states flag 90865 as requiring prior authorization (always or conditionally) on their fee schedules. States without a flag publish no PA indicator for this code - that means "not published", not "no PA required".