This report presents estimated incidence rates of first episode psychosis (FEP) among the Washington Medicaid population in state fiscal year (SFY) 2023. Using administrative data from 1997 forward, we identified 4,106 Medicaid enrollees in Washington State who received their first psychotic disorder diagnoses in SFY 2023. The overall incidence rate of FEP was estimated at 248 per 100,000 Medicaid enrollees. The demographic characteristics, type of psychotic disorder diagnosis, and geographic distribution of Medicaid enrollees experiencing FEP are presented in the report.