H0040 Medicaid reimbursement rates by state
Assertive community treatment program, per diem. 16 state Medicaid programs publish a fee-for-service rate for H0040 at the unlicensed practitioner level. Rates run from $1.00 in Arkansas to $3,788.02 in California, with a median of $217.12.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 16
- Median rate
- $217.12units vary by state
- Highest
- $3,788.02California
- Medicare (non-facility)
- —not on the physician fee schedule
H0040 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 |
|---|---|---|---|---|---|---|
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal Specialty Mental Health Services (DHCS fee schedule for county Mental Health Plans) | $3,788.02since 2026-07-01 | 4.0 to 5.0 Encounters (3.0 encounters must be FTF*) | — | Paid by the state, outside plans | — | Medi-Cal Behavioral Health Fee Schedules |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $1,651.25⚠ over 3× mediansince 2025-01-01 | day | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Public Behavioral Health System (specialty mental health, SUD and ABA, paid fee-for-service through the Carelon ASO) | $1,330.41⚠ over 3× mediansince 2024-07-01 | day | — | Paid by the state, outside plans | — | FY2025 PBHS Fee Schedule – PRP and Speci |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $750.00since 2020-01-01 | month | — | Plans negotiate; applies out of network | — | DMS CMHC Mental Health Substance Abuse f |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $386.72since 2025-10-01 | Event, maximum 4 per month | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Enhanced Menta |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $272.97since 2026-01-01 | day | — | Plans must pass increases through | — | Assertive Community Treatment (ACT) Prov |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $235.22since 2024-01-01 | day | — | Plans must pay at least this | — | DMAS procedure fee file hcpcmedical.csv |
| OhioUnlicensed (bachelor's/master's) behavioral health practitioner · Ohio Medicaid (fee-for-service) | $225.16since 2024-01-01 | day | — | Plans expected to pay at least this | — | OAC 5160-27-03 Appendix A, Community Beh |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $209.07since 2022-07-01 | day | — | Paid by the state, outside plans | — | MO HealthNet fee schedule: Community Psy |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $182.49since 2024-01-01 | day | — | Plans negotiate; applies out of network | — | HCA Specialized mental health fee schedu |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $157.75since 2026-07-01 | day | — | Not classified | — | SCDHHS Rehabilitative Behavioral Health |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $83.91since 2024-07-01 | day | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $59.43since 2026-07-01 | day | — | Plans negotiate; applies out of network | — | Nebraska Medicaid Mental Health and Subs |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $31.55since 2026-01-01 | day | — | Plans negotiate; applies out of network | — | Community Behavioral Health Services Fee |
| AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $31.50since 2025-07-01 | day | — | Not classified | — | Rehab Option MI Fee Schedule |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $1.00since 2025-06-13 | day | — | Not classified | — | Arkansas Medicaid Nurse Practitioner Fee |
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 H0040?
It depends on the state. Of the 16 states with a published fee-for-service rate, the median is $217.12. California pays the most ($3,788.02 per 4.0 to 5.0 Encounters (3.0 encounters must be FTF*)) and Arkansas the least ($1.00 per day).
Which state pays the highest Medicaid rate for H0040?
California, at $3,788.02 per 4.0 to 5.0 Encounters (3.0 encounters must be FTF*), effective 2026-07-01.
Do managed-care plans pay the same rate for H0040?
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.