H1003 Medicaid reimbursement rates by state
Prenatal care, at-risk enhanced service; education. 8 state Medicaid programs publish a fee-for-service rate for H1003 at the physician psychologist level. Rates run from $3.89 in Colorado to $615.52 in New Jersey, with a median of $13.86.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 8
- Median rate
- $13.86units vary by state
- Highest
- $615.52New Jersey
- Medicare (non-facility)
- —not on the physician fee schedule
H1003 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 |
|---|---|---|---|---|---|---|
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $615.52⚠ over 3× mediansince 2026-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $294.00⚠ over 3× mediansince 2026-02-01 | — | — | Plans must pass increases through | — | MHCP Fee Schedule - Current Fee Schedule |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $16.50since 2023-02-01 | — | — | Paid by the state, outside plans | — | ForwardHealth max fee schedule: Pn/Chld |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $15.61since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Appendix DD to OAC 5160-1-60 (Non-Instit |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $12.10since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Part II Policies and Procedures for Peri |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $10.00since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $6.78since 2024-01-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $3.89since 2026-07-01 | encounter | — | Not classified | — | July 2026 Prenatal Plus and Special Conn |
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 H1003?
It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $13.86. New Jersey pays the most ($615.52) and Colorado the least ($3.89 per encounter).
Which state pays the highest Medicaid rate for H1003?
New Jersey, at $615.52, effective 2026-01-01.
Do managed-care plans pay the same rate for H1003?
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.