H0022 Medicaid reimbursement rate by state (2026)
Alcohol and/or drug intervention service. Medicaid pays a median of $20.73 for H0022 across 6 states, from $8.25 in Oklahoma to $400.00 in Rhode Island.
- States publishing
- 6
- National median
- $20.73units vary by state
- Lowest
- $8.25Oklahoma
- Highest
- $400.00Rhode Island
What does Medicaid pay for H0022?
6 state Medicaid programs publish a fee-for-service rate for H0022. The national median is $20.73 (units differ between states). Rhode Island pays the most, $400.00, and Oklahoma the least, $8.25 per 15 min, a 48.5x spread.
H0022 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 6 states with every variant, modifier and effective date.
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 H0022, 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. 3 of the 6 states list more than one rate for H0022, 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 6 states, 1 publish H0022 per unit, 1 per per quarter unit and 1 per 15 min, and 3 schedules print no unit at all (a flat amount per service).
- Per hour. Time-based units are converted to an hour of service (four 15-minute units make an hour). 1 of the 6 states bill H0022 by time.
- Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
- % of Medicare. No Medicare physician fee schedule amount is on file for H0022, so there is no percentage.
- Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Why H0022 rates differ between states
Published rates for H0022 run from $8.25 in Oklahoma to $400.00 in Rhode Island. The two publish it in different units (no unit printed versus 15 min), so part of that gap is the unit rather than the price. Half the states pay more than the median of $20.73 and half pay less. The usual reasons for a spread like this in behavioral health rates:
- Many states pay behavioral health services differently by the practitioner's credential, from psychiatrist and psychologist to licensed clinical social worker, counselor and peer specialist.
- Community mental health and substance use services are often billed under H and T codes that each state defines for itself, so the same code can describe a different service in two states.
- Behavioral health is frequently run through a separate state agency, a carve-out or a specialty plan, with its own rate-setting cycle.
Timing matters too. 1 state set the current rate for H0022 in 2026 or later, while 2 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.
What managed-care plans pay for H0022
Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For H0022, the public signal is the rule each state sets for its plans, recorded on each rate above.
In 2 states, plans negotiate and the published rate is a benchmark or out-of-network default. In 2 states, the service is paid outside the plans or through a state-directed payment. The rule for the remaining 2 states is not classified yet.
- Paid by the state, outside the plans (2 states). Bill the state's Medicaid program, not the plan, at the published rate. There is no plan contract to negotiate for this service.
- Plans negotiate; the published rate applies out of network (2 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.
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 Rhode Island managed care.
Units and billing for H0022
H0022 is a HCPCS Level II behavioral health code in the behavioral health line, billed mostly by psychiatrists, psychologists, licensed clinicians and community mental health agencies. H codes were created for state Medicaid agencies to bill mental health and substance use services. Each state defines the unit, which may be 15 minutes, an hour, a day or an episode.
Modifiers such as HO (master's level), HN (bachelor's level) and HP (doctoral level) identify the practitioner, and many states publish a different rate for each. Psychotherapy codes are defined by session length, so one unit is one session of the stated duration; H codes are billed in whatever unit the state defines, often 15 minutes, an hour or a day.
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.
Frequently asked questions
What does Medicaid pay for H0022?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $20.73. Rhode Island pays the most ($400.00) and Oklahoma the least ($8.25 per 15 min).
Which state pays the highest Medicaid rate for H0022?
Rhode Island, at $400.00, effective 2016-11-01.
Which state pays the lowest Medicaid rate for H0022?
Oklahoma, at $8.25 per 15 min ($33.00 per hour), effective 2024-05-22. It publishes the code in a different unit from Rhode Island, so compare per unit with care.
What unit is H0022 billed in?
Of the 6 states, 1 publish H0022 per unit, 1 per per quarter unit and 1 per 15 min, and 3 schedules print no unit at all (a flat amount per service). 1 of the 6 states bill it by time, and their rates are also shown per hour.
Do managed-care plans pay the same rate for H0022?
Not necessarily. In 2 states, plans negotiate and the published rate is a benchmark or out-of-network default. In 2 states, the service is paid outside the plans or through a state-directed payment. The rule for the remaining 2 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.