H0012 Medicaid reimbursement rates by state
Alcohol and/or drug services; sub-acute detoxification. 13 state Medicaid programs publish a fee-for-service rate for H0012 at the physician psychologist level. Rates run from $88.95 in Texas to $456.97 in Montana, with a median of $305.44.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 13
- Median rate
- $305.44units vary by state
- Highest
- $456.97Montana
- Medicare (non-facility)
- —not on the physician fee schedule
H0012 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 |
|---|---|---|---|---|---|---|
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $456.97since 2025-07-01 | week | — | Not classified | — | Substance Use Disorder (Chemical Depende |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $442.70since 2022-11-15 | — | — | Not classified | — | CMAP fee schedule: Free-Standing Substan |
| OhioAgency provider · Ohio Medicaid (fee-for-service) | $406.31since 2024-01-01 | day | — | Plans expected to pay at least this | — | OAC 5160-27-03 Appendix A, Community Beh |
| DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP) | $334.27since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | DMAP 2024 Physician Fee Schedule |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $323.76since 2022-07-01 | — | — | Paid by the state, outside plans | — | MO HealthNet fee schedule: Comprehensive |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $308.97since 2026-01-01 | day | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Enhanced Menta |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Drug Medi-Cal in State Plan (non-ODS) counties | $305.44since 2026-07-01 | 24 Hour | — | Paid by the state, outside plans | — | Medi-Cal Behavioral Health Fee Schedules |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $244.15since 2026-07-01 | day | — | Plans negotiate; applies out of network | — | Nebraska Medicaid Mental Health and Subs |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $202.07since 2024-07-01 | day | — | Plans negotiate; applies out of network | — | OHP FFS behavioral health fee schedule ( |
| North DakotaAny qualified provider (rate does not vary by provider) · North Dakota Medicaid (fee-for-service) | $199.90since 2026-07-01 | — | — | Not classified | — | ND Medicaid Behavioral Health Services F |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $184.62since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| KentuckyPhysician or licensed psychologist (incl. BCBA-D) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $107.44since 2020-01-01 | encounter | — | Plans negotiate; applies out of network | — | DMS CMHC Mental Health Substance Abuse f |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $88.95since 2022-03-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Outpa |
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 H0012?
It depends on the state. Of the 13 states with a published fee-for-service rate, the median is $305.44. Montana pays the most ($456.97 per week) and Texas the least ($88.95).
Which state pays the highest Medicaid rate for H0012?
Montana, at $456.97 per week, effective 2025-07-01.
Do managed-care plans pay the same rate for H0012?
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.