S0281 Medicaid reimbursement rates by state
Medical home program. 8 state Medicaid programs publish a fee-for-service rate for S0281 at the physician psychologist level. Rates run from $12.50 in Nevada to $380.56 in Virginia, with a median of $117.50.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 8
- Median rate
- $117.50units vary by state
- Highest
- $380.56Virginia
- Medicare (non-facility)
- —not on the physician fee schedule
S0281 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 |
|---|---|---|---|---|---|---|
| VirginiaCase manager / support coordinator · Virginia Medicaid (fee-for-service, DMAS) | $380.56⚠ over 3× mediansince 2023-07-01 | — | — | Plans must pay at least this | — | DMAS procedure fee file hcpcmedical.csv |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $245.00since 2026-05-21 | One payment per month | — | State sets the plan rate | — | MH Procedure CPT or HCPC Codes and Rates |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid community palliative care benefit (QI / CCS / FFS) | $200.00since 2025-01-01 | $200 (maximum | — | Not classified | — | Med-QUEST memo QI-2430A |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $150.00since 2022-01-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Nurse Practiti |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $85.00since 2026-06-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $51.34since 2026-07-01 | — | — | Not classified | — | South Dakota Medicaid Physician fee sche |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $13.14since 2014-04-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: BHIC (BH |
| NevadaAny qualified provider (rate does not vary by provider) · Nevada HCBS Waiver for Individuals with Intellectual and Developmental Disabilities (provider type 38, fee-for-service) | $12.50since 2022-09-01 | 15 min | $50.00 | Paid by the state, outside plans | — | Provider Type 38, Waiver for Individuals |
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 S0281?
It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $117.50. Virginia pays the most ($380.56) and Nevada the least ($12.50 per 15 min).
Which state pays the highest Medicaid rate for S0281?
Virginia, at $380.56, effective 2023-07-01.
Do managed-care plans pay the same rate for S0281?
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.