G9012 Medicaid reimbursement rates by state
Other specified case management service not elsewhere.... 19 state Medicaid programs publish a fee-for-service rate for G9012 at the case manager level. Rates run from $3.40 in Washington to $258.80 in Virginia, with a median of $22.56.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 19
- Median rate
- $22.56units vary by state
- Highest
- $258.80Virginia
- Medicare (non-facility)
- —not on the physician fee schedule
G9012 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 |
|---|---|---|---|---|---|---|
| VirginiaCase manager / support coordinator · Virginia Medicaid (fee-for-service, DMAS) | $258.80⚠ over 3× mediansince 2025-07-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
| FloridaCase manager / support coordinator · Florida iBudget waiver for people with developmental disabilities (APD) | $183.37since 2026-07-01 | month | — | Paid by the state, outside plans | — | Florida Medicaid Developmental Disabilit |
| TexasCase manager / support coordinator · Texas Medicaid (fee-for-service, TMHP) | $122.31⚠ over 3× mediansince 2025-03-14 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Case |
| South CarolinaCase manager / support coordinator · South Carolina Community Long Term Care waivers (Community Choices, HIV/AIDS, Mechanical Ventilator Dependent; 1915(c)) | $86.00since 2025-11-01 | month | — | Paid by the state, outside plans | — | SCDHHS HCBS Waivers Fee Schedule (Effect |
| MichiganCase manager / support coordinator · Michigan Medicaid (fee-for-service) | $50.00since 2023-07-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Targeted Case Management Services |
| PennsylvaniaRegistered nurse (RN) · Pennsylvania Medical Assistance (fee-for-service) | $46.20since 2025-10-12 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $42.89since 2009-01-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $35.77since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| IowaCase manager / support coordinator · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $28.59since 2024-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #48 CLINICAL |
| ColoradoAny qualified provider (rate does not vary by provider) · Colorado HCBS waiver for children with a life-limiting illness (CLLI) | $22.56since 2024-07-01 | 15 min | $90.24 | Paid by the state, outside plans | — | CLLI, CHCBS, CHRP (effective July 1, 202 |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $20.60since 2004-04-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $19.60since 2021-10-01 | 1/4 hr | — | Plans negotiate; applies out of network | — | HFS Community Based Behavioral Services |
| ConnecticutCase manager / support coordinator · Connecticut Mental Health Waiver (WISE, DMHAS-operated 1915(c)) | $17.09since 2021-07-01 | — | — | Not classified | — | CMAP fee schedule: Mental Health Waiver |
| LouisianaCase manager / support coordinator · Louisiana Community Choices Waiver (OAAS 1915(c) waiver for older adults and adults with disabilities) | $15.55since 2026-10-01 | 15 min | $62.20 | Paid by the state, outside plans | — | Community Choices Waiver services proced |
| North CarolinaCase manager / support coordinator · North Carolina Medicaid Direct (fee-for-service) | $12.96since 2025-10-01 | — | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'HIV Case Manag |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $11.25since 2004-01-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| MissouriCase manager / support coordinator · Missouri MO HealthNet (fee-for-service) | $8.64since 2015-07-01 | — | — | Plans negotiate; applies out of network | — | MO HealthNet fee schedule: Targeted Case |
| AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $5.00since 2026-04-01 | — | — | Not classified | — | TCM Referral Fee Schedule |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $3.40since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Physician-related services fee sched |
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 G9012?
It depends on the state. Of the 19 states with a published fee-for-service rate, the median is $22.56. Virginia pays the most ($258.80) and Washington the least ($3.40).
Which state pays the highest Medicaid rate for G9012?
Virginia, at $258.80, effective 2025-07-01.
Do managed-care plans pay the same rate for G9012?
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.