H0047 Medicaid reimbursement rates by state
Alcohol and/or other drug abuse services. 15 state Medicaid programs publish a fee-for-service rate for H0047 at the licensed clinician level. Rates run from $4.80 in Virginia to $458.02 in North Carolina, with a median of $28.36.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 15
- Median rate
- $28.36units vary by state
- Highest
- $458.02North Carolina
- Medicare (non-facility)
- —not on the physician fee schedule
H0047 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 |
|---|---|---|---|---|---|---|
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $458.02since 2026-01-01 | day | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Enhanced Menta |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $360.65since 2025-07-01 | day | — | Plans negotiate; applies out of network | — | HFS Fee Schedule for Substance Use Preve |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $124.86since 2024-04-01 | WEEKLY NTP | — | Plans negotiate; applies out of network | — | KY Medicaid Behavioral Health fee schedu |
| 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) | $85.31since 2024-07-01 | Per Week | — | Paid by the state, outside plans | — | FY2025 PBHS Fee Schedule – SUD_7.1.2024 |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $78.41since 2026-07-01 | — | — | Plans must pay at least this | — | Rates for Certain Substance-Related and |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $57.78since 2024-07-01 | — | — | Plans must pay at least this | — | Provider Type 26 Psychologist Reimbursem |
| ColoradoAny qualified provider (rate does not vary by provider) · Colorado HCBS waiver for persons with a brain injury (BI) | $36.69since 2026-07-01 | hour | $36.69 | Paid by the state, outside plans | — | EBD, CMHS, BI, CIH (effective July 1, 20 |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $28.36since 2023-02-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Mntl Hlt |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $27.19since 2025-01-01 | — | — | Plans must pass increases through | — | MHCP Fee Schedule - Current Fee Schedule |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $25.39since 2013-07-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Outpa |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $19.83since 2025-07-01 | day | — | Plans must pay at least this | — | Specialized Behavioral Health Services f |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $15.13since 2026-01-01 | one time | — | Plans negotiate; applies out of network | — | Community Behavioral Health Services Fee |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington ALTSA home and community services (other HCBS) | $15.00since 2021-07-01 | EA | — | Paid by the state, outside plans | — | DSHS ORM Home & Community Based Rates Hi |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $12.67since 2019-07-01 | — | — | Paid by the state, outside plans | — | MO HealthNet fee schedule: Community Psy |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $4.80since 2008-07-01 | — | — | Not classified | — | DMAS procedure fee file hcpcmedical.csv |
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 H0047?
It depends on the state. Of the 15 states with a published fee-for-service rate, the median is $28.36. North Carolina pays the most ($458.02 per day) and Virginia the least ($4.80).
Which state pays the highest Medicaid rate for H0047?
North Carolina, at $458.02 per day, effective 2026-01-01.
Do managed-care plans pay the same rate for H0047?
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.