H0045 Medicaid reimbursement rates by state
Respite care services, not in the home, per diem. 11 state Medicaid programs publish a fee-for-service rate for H0045 at the agency level. Rates run from $7.08 in New Jersey to $733.94 in Washington, with a median of $173.52.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 11
- Median rate
- $173.52units vary by state
- Highest
- $733.94Washington
- Medicare (non-facility)
- —not on the physician fee schedule
H0045 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 |
|---|---|---|---|---|---|---|
| WashingtonAny qualified provider (rate does not vary by provider) · Washington DDA waiver and state plan services (Basic Plus, Core, IFS, CIIBS, CP) | $733.94since 2026-01-01 | DL | — | Paid by the state, outside plans | — | DSHS ORM All DDA Rates |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri DD Community Support Waiver (DMH Division of DD, 1915(c)) | $661.96⚠ over 3× mediansince 2024-07-01 | day | — | Paid by the state, outside plans | — | MO HealthNet fee schedule: Community Sup |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina CAP consumer-directed option (CAP/CD) | $219.57since 2025-10-01 | day | — | Paid by the state, outside plans | — | NC Medicaid fee schedule 'CAP- Consumer |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Home Care Waiver (ODM) | $199.82since 2026-04-17 | day | — | Plans negotiate; applies out of network | — | OAC 5160-46-06 (Register of Ohio final f |
| ColoradoAny qualified provider (rate does not vary by provider) · Colorado HCBS waiver for persons who are elderly, blind or disabled (EBD) | $190.18since 2026-07-01 | day | — | Paid by the state, outside plans | — | EBD, CMHS, BI, CIH (effective July 1, 20 |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Alternative Care (AC, state-funded program for people 65+) | $173.52since 2026-01-01 | day | — | Not classified | — | Long-Term Services and Supports Service |
| 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) | $119.84since 2025-11-01 | day | — | Paid by the state, outside plans | — | FY2027 PBHS Fee Schedule – PRP and Speci |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $91.28since 2026-10-01 | day | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| TexasAgency provider · Texas Home and Community-Based Services - Adult Mental Health (HCBS-AMH, 1915(i)) | $82.56since 2025-09-01 | day | — | Not classified | — | HHSC PFD HCBS-AMH payment rates (9-1-202 |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medically Fragile, Technology Dependent waiver (IL.0278) and EPSDT in-home nursing, operated by UIC-DSCC | $57.78since 2025-01-01 | Client Hour | — | Not classified | — | Medically Fragile Technology Dependent ( |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $7.08since 2025-01-01 | day | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
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 H0045?
It depends on the state. Of the 11 states with a published fee-for-service rate, the median is $173.52. Washington pays the most ($733.94 per DL) and New Jersey the least ($7.08 per day).
Which state pays the highest Medicaid rate for H0045?
Washington, at $733.94 per DL, effective 2026-01-01.
Do managed-care plans pay the same rate for H0045?
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.