97130 Medicaid reimbursement rate by state (2026)
Cognitive skills therapy, each added unit. Medicaid pays a median of $18.52 for 97130 across 38 states, from $6.75 in Louisiana to $40.92 in Alaska.
- States publishing
- 38
- National median
- $18.52units vary by state
- Lowest
- $6.75Louisiana
- Highest
- $40.92Alaska
- Median per hour
- $74.0636 time-based states
What does Medicaid pay for 97130?
38 state Medicaid programs publish a fee-for-service rate for 97130. The national median is $18.52 (units differ between states). Alaska pays the most, $40.92 per 15 min, and Louisiana the least, $6.75 per 15 min, a 6.1x spread. Converted to an hour of service in the 36 states that bill it by time, the median is $74.06 per hour. Where the billing unit matches Medicare's, Medicaid pays between 33% and 149% of the 2026 Medicare physician fee schedule amount for the state.
Medicare (non-facility, 2026 physician fee schedule): $20.35–$29.38 depending on the state's Medicare locality.
97130 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 38 states with every variant, modifier and effective date.
Frequently asked questions
What does Medicaid pay for 97130?
It depends on the state. Of the 38 states with a published fee-for-service rate, the median is $18.52. Alaska pays the most ($40.92 per 15 min) and Louisiana the least ($6.75 per 15 min).
Which state pays the highest Medicaid rate for 97130?
Alaska, at $40.92 per 15 min ($163.68 per hour), effective 2026-07-01.
How do Medicaid rates for 97130 compare with Medicare?
Where the billing units match, Medicaid pays between 33% and 149% of the 2026 Medicare physician fee schedule amount for the state (non-facility).
Do managed-care plans pay the same rate for 97130?
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 workspace shows the rule for each state, cited to the contract or statute.