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Billing code 92608 · Therapy (PT/OT/speech)

92608 Medicaid reimbursement rate by state (2026)

Speech-generating device evaluation. Medicaid pays a median of $37.39 for 92608 across 42 states, from $6.34 in Kansas to $127.41 in Arizona.

Data as of Oct 5, 202642 statesEvery rate links to its official source

States publishing
42
National median
$37.39units vary by state
Lowest
$6.34Kansas
Highest
$127.41Arizona
Answer

What does Medicaid pay for 92608?

42 state Medicaid programs publish a fee-for-service rate for 92608. The national median is $37.39 (units differ between states). Arizona pays the most, $127.41, and Kansas the least, $6.34, a 20.1x spread.

Medicare (non-facility, 2026 physician fee schedule): $44.33–$61.11 depending on the state's Medicare locality.

State ranking

92608 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 42 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Arizona Source · since 2025-10-01$127.41——Plans negotiate; applies out of network—
2Alaska Source · since 2026-07-01$72.25——Not classified—
3New Mexico Source · since 2025-01-01$68.53——Plans must pay at least this—
21Michigan Source · since 2026-01-01$37.47——Plans negotiate; applies out of network—
22Minnesota Source · since 2026-02-01$37.30——Plans negotiate; applies out of network—
23Massachusetts Source · since 2026-10-01$37.09——Plans negotiate; applies out of network—
41Rhode Island Source · since 2003-01-01$12.18——Plans negotiate; applies out of network—
42Kansas Source · since 2009-12-18$6.34——Not classified—
See all 42 states for 92608 — start free

34 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

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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; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track 92608 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
Guide

How to read this table

  • Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for 92608, so the order is by published amount and is not a like-for-like rank.
  • Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 28 of the 42 states list more than one rate for 92608, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
  • Unit. Of the 42 states, 2 publish 92608 per unit and 1 per 30 min, and 39 schedules print no unit at all (a flat amount per service).
  • Per hour. 92608 is not billed in time units in these states, so no hourly figure is shown.
  • Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
  • % of Medicare. Medicare amounts exist for 92608, but no state's Medicaid unit matches Medicare's billing unit closely enough to compute a percentage.
  • Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Context

Why 92608 rates differ between states

Published rates for 92608 run from $6.34 in Kansas to $127.41 in Arizona, a 20.1x gap in the same unit. Half the states pay more than the median of $37.39 and half pay less. The usual reasons for a spread like this in therapy (PT/OT/speech) rates:

  • States pay therapy by CPT code, but many pay therapy assistants a reduced percentage and some pay differently in outpatient hospital, private practice and home settings.
  • Children's therapy is driven by the EPSDT benefit, so some states maintain separate pediatric rates or programs.
  • Visit limits, prior authorization and annual caps vary by state and change how much a single code is worth to a practice.

Timing matters too. 27 states set the current rate for 92608 in 2026 or later, while 6 states still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.

Managed care

What managed-care plans pay for 92608

Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For 92608, the public signal is the rule each state sets for its plans, recorded on each rate above.

In 8 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 20 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 14 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (20 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.
  • Plans must pay at least the published rate (8 states). The published rate is your floor. Negotiate up from it, and if a plan pays less, the contract provision is the basis for a payment dispute.

Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example Arizona managed care.

Billing

Units and billing for 92608

92608 is a CPT medicine code in the therapy (PT/OT/speech) line, billed mostly by physical, occupational and speech therapists and therapy practices. The medicine section runs from vaccines and psychiatry to dialysis, cardiology and therapy. Some of its codes are timed in 15-minute units, others are billed once per session or per test, so the unit matters more here than in most sections.

Many treatment codes are timed in 15-minute units, while evaluations and re-evaluations are billed once per session. Medicare applies a rule for counting timed minutes into units; Medicaid programs may follow it or set their own, so check the state's therapy manual.

Medicare's 2026 physician fee schedule pays $44.33–$61.11 for 92608 (non-facility), depending on the Medicare locality. That is a useful reference point, but Medicare and Medicaid can define the unit differently, so compare only where the units match.

Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.

FAQ

Frequently asked questions

What does Medicaid pay for 92608?

It depends on the state. Of the 42 states with a published fee-for-service rate, the median is $37.39. Arizona pays the most ($127.41) and Kansas the least ($6.34).

Which state pays the highest Medicaid rate for 92608?

Arizona, at $127.41, effective 2025-10-01.

Which state pays the lowest Medicaid rate for 92608?

Kansas, at $6.34, effective 2009-12-18.

What unit is 92608 billed in?

Of the 42 states, 2 publish 92608 per unit and 1 per 30 min, and 39 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for 92608?

Not necessarily. In 8 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 20 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 14 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.