97112 Medicaid reimbursement rates by state
Balance and coordination retraining. 21 state Medicaid programs publish a fee-for-service rate for 97112 at the therapist pt level. Rates run from $12.22 in California to $3,510.00 in New Jersey, with a median of $23.55.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 21
- Median rate
- $23.55units vary by state
- Highest
- $3,510.00New Jersey
- Medicare (non-facility)
- $30.56–$41.352026 physician fee schedule
97112 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 |
|---|---|---|---|---|---|---|
| New JerseyPhysical therapist · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $3,510.00⚠ over 3× mediansince 2025-12-01 | 15 min | $14,040.00 | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $33.75since 2017-09-01 | 15 min | $135.00 | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| IndianaPhysical therapist · Indiana Medicaid (fee-for-service) | $30.65since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $30.59since 2026-10-01 | 15 min | $122.36 | Plans negotiate; applies out of network | 95% | AHCCCS Arizona Health Care Cost Containm |
| MissouriPhysical therapist · Missouri MO HealthNet (fee-for-service) | $28.61since 2022-07-01 | 15 min | $114.44 | Plans must pay at least this | 89–94% | MO HealthNet fee schedule: Podiatry |
| MarylandPhysical therapist · Maryland Medicaid (fee-for-service, MDH) | $27.85since 2026-01-01 | 15 min | $111.40 | Not classified | 81–84% | Maryland Medicaid Professional Services |
| ColoradoPhysical therapist · Child Health Plan Plus (CHP+, Colorado's CHIP) | $27.42since 2026-07-01 | 15 min | $109.68 | Plans negotiate; applies out of network | 81% | Child Health Plan Plus FY 2026-2027 Fee |
| NebraskaPhysical therapist · Nebraska Medicaid (fee-for-service) | $27.42since 2026-07-01 | 15 min | $109.68 | Plans negotiate; applies out of network | 88% | Nebraska Medicaid fee schedule 471-000-5 |
| MassachusettsPhysical therapist · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $25.83since 2026-10-01 | 15 min | $103.32 | Plans negotiate; applies out of network | 71–77% | Emergency Adoption (date filed: Septembe |
| MinnesotaPhysical therapist · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $25.21since 2026-02-01 | 15 min | $100.84 | Plans negotiate; applies out of network | 77% | MHCP Fee Schedule - Current Fee Schedule |
| North CarolinaPhysical therapist · North Carolina Medicaid Direct (fee-for-service) | $23.55since 2025-10-01 | 15 min | $94.20 | Plans negotiate; applies out of network | 75% | NC Medicaid fee schedule 'Occupational T |
| IllinoisPhysical therapist · Illinois Medicaid (HFS fee-for-service) | $21.63since 2024-04-01 | 15 min | $86.52 | Plans negotiate; applies out of network | 65–69% | HFS Practitioner Fee Schedule (effective |
| GeorgiaPhysical therapist · Georgia Medicaid (fee-for-service) | $21.03since 2023-04-01 | 15 min | $84.12 | Plans negotiate; applies out of network | 64–68% | Max Allow Payment_OutP Site of Service A |
| MichiganPhysical therapist · Michigan Medicaid (fee-for-service) | $20.87since 2026-01-01 | 15 min | $83.48 | Plans negotiate; applies out of network | 64–66% | MDHHS Occupational Therapy Fee Schedule |
| FloridaPhysical therapist · Florida Medicaid (fee-for-service) | $20.33since 2026-01-01 | 15 min | $81.32 | Plans negotiate; applies out of network | 60–63% | Physical Therapy Fee Schedule (Physical |
| WisconsinPhysical therapist · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $20.29since 2022-01-01 | 15 min | $81.16 | Plans negotiate; applies out of network | 64% | ForwardHealth max fee schedule: Therapy- |
| WashingtonPhysical therapist · Washington Apple Health (Medicaid) fee-for-service | $19.87since 2026-07-01 | 15 min | $79.48 | Plans negotiate; applies out of network | 54–59% | HCA Habilitative services fee schedule ( |
| OhioPhysical therapist · Ohio Medicaid School Program (school-based services) | $18.50since 2020-06-12 | 15 min | $74.00 | Paid by the state, outside plans | 59% | Appendix DD to OAC 5160-1-60 (Non-Instit |
| VirginiaPhysical therapist · Virginia Medicaid (fee-for-service, DMAS) | $18.31since 2019-12-01 | 15 min | $73.24 | Plans negotiate; applies out of network | 57% | DMAS procedure fee file cptmedical4.csv |
| PennsylvaniaPhysical therapist · Pennsylvania Medical Assistance (fee-for-service) | $16.75since 2021-09-01 | 15 min | $67.00 | Plans negotiate; applies out of network | 50–53% | PA DHS PROMISe Outpatient Fee Schedule ( |
| CaliforniaPhysical therapist · California Medi-Cal (fee-for-service) | $12.22since 2026-10-01 | 15 min | $48.88 | Plans negotiate; applies out of network | 30–36% | Medi-Cal Rates (Rates files zip: rates_d |
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 97112?
It depends on the state. Of the 21 states with a published fee-for-service rate, the median is $23.55. New Jersey pays the most ($3,510.00 per 15 min) and California the least ($12.22 per 15 min).
Which state pays the highest Medicaid rate for 97112?
New Jersey, at $3,510.00 per 15 min ($14,040.00 per hour), effective 2025-12-01.
How do Medicaid rates for 97112 compare with Medicare?
Where the billing units match, Medicaid pays between 33% and 95% of the 2026 Medicare physician fee schedule amount for the state (non-facility).
Do managed-care plans pay the same rate for 97112?
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.