H0035 Medicaid reimbursement rates by state
Mental health partial hospitalization, treatment. 24 state Medicaid programs publish a fee-for-service rate for H0035 at the physician psychologist level. Rates run from $0.01 in Rhode Island to $750.00 in Kansas, with a median of $221.05.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 24
- Median rate
- $221.05units vary by state
- Highest
- $750.00Kansas
- Medicare (non-facility)
- —not on the physician fee schedule
H0035 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 |
|---|---|---|---|---|---|---|
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $750.00⚠ over 3× mediansince 2025-01-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| AlaskaAny qualified provider (rate does not vary by provider) · Alaska 1115 Behavioral Health waiver services | $714.11⚠ over 3× mediansince 2026-07-01 | day | — | Not classified | — | Chart of (Behavioral Health Reform) 1115 |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $500.00since 2024-01-01 | — | — | Plans must pay at least this | — | DMAS procedure fee file hcpcmedical.csv |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $500.00since 2025-07-01 | — | — | Plans must pay at least this | — | Provider Type 20 Physician, MD., Osteopa |
| North DakotaAny qualified provider (rate does not vary by provider) · North Dakota Medicaid (fee-for-service) | $470.59since 2026-07-01 | — | — | Not classified | — | ND Medicaid Behavioral Health Services F |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $337.75since 2026-07-01 | — | — | Not classified | — | Vermont Medicaid Fee Schedule - HCPCS (i |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $325.12since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $322.40since 2019-07-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $302.06since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Fee Schedule Final FFS Behavi |
| DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP) | $283.89since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | DMAP 2024 Physician Fee Schedule |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $240.42since 2026-01-01 | — | — | Not classified | — | CMAP fee schedule: Clinic and Outpatient |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $228.05since 2024-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2024-2025 Rate |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $214.05since 2022-10-12 | — | — | Not classified | — | Arkansas Medicaid Adult Behavioral Healt |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $203.03since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | HCA Specialized mental health fee schedu |
| AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $195.00since 2023-10-01 | 4 hours | — | Not classified | — | Department of Mental Health Substance Us |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $194.10since 2020-01-01 | day | — | Plans negotiate; applies out of network | — | DMS CMHC Mental Health Substance Abuse f |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $180.00since 2025-07-01 | day | — | Plans must pay at least this | — | ODMHSAS PICIS 'Rates and Codes for Agenc |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $165.88since 2025-10-01 | day | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Enhanced Menta |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $135.23since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $130.85since 2024-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, June 202 |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $93.32since 2025-07-01 | Half Day | — | Not classified | — | Medicaid Youth Mental Health Fee Schedul |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $20.88since 2025-01-01 | — | — | Plans must pay at least this | — | NJMMIS Procedure Master Listing CPTHCPCS |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $14.00since 2022-07-01 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid behavioral health programs (CMHC, ACT, BH Link, peer, SUD, health homes; fee-for-service) | $0.01since 2024-10-01 | — | — | Plans negotiate; applies out of network | — | RI Medicaid Interactive Fee For Service |
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 H0035?
It depends on the state. Of the 24 states with a published fee-for-service rate, the median is $221.05. Kansas pays the most ($750.00) and Rhode Island the least ($0.01).
Which state pays the highest Medicaid rate for H0035?
Kansas, at $750.00, effective 2025-01-01.
Do managed-care plans pay the same rate for H0035?
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.
Related Behavioral health codes
90791Mental health assessment (non-physician) · 50 states90832Outpatient psychotherapy and diagnostic evaluation · 50 states90834Outpatient psychotherapy and diagnostic evaluation · 50 states90837Outpatient psychotherapy and diagnostic evaluation · 50 states90847Outpatient psychotherapy and diagnostic evaluation · 50 states90853Outpatient psychotherapy and diagnostic evaluation · 50 states96130Mental health assessment (non-physician) · 50 states96131Mental health assessment (non-physician) · 50 states96136Mental health assessment (non-physician) · 50 states96137Mental health assessment (non-physician) · 50 states99202New-patient office visit, level 1 of 4 · 50 states99203New-patient office visit, level 2 of 4 · 50 states
Track H0035 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.