T1000 Medicaid reimbursement rates by state
Private duty / independent nursing service(s) - licensed. 22 state Medicaid programs publish a fee-for-service rate for T1000 at the rn level. Rates run from $8.16 in Florida to $140.80 in South Carolina, with a median of $15.35.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 22
- Median rate
- $15.35units vary by state
- Highest
- $140.80South Carolina
- Medicare (non-facility)
- —not on the physician fee schedule
T1000 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 |
|---|---|---|---|---|---|---|
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $140.80⚠ over 3× mediansince 2017-07-01 | 15 min | $563.20 | Not classified | — | SCDHHS Physician Assistant/Nurse Practit |
| IllinoisRegistered nurse (RN) · Illinois Persons with Brain Injury waiver (DHS-DRS Home Services Program, IL.0329) | $36.75since 2026-07-01 | hour | $36.75 | Plans must pay at least this | — | HSP Rates and Fees (Medicaid Waiver Serv |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid home care and personal care (fee-for-service) | $23.60since 2026-10-01 | 15 min | $94.40 | Plans negotiate; applies out of network | — | RI Medicaid Interactive Fee For Service |
| South DakotaRegistered nurse (RN) · South Dakota Assistive Daily Living Services (ADLS) Waiver (1915(c)) | $23.20since 2026-07-01 | up to 15 minutes | — | Not classified | — | South Dakota Medicaid Assistive Daily Li |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $20.05since 2025-07-01 | 15 min | $80.20 | Plans must pay at least this | — | DMAS procedure fee file hcpcmedical.csv |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $20.00since 2026-07-01 | 15 min | $80.00 | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| MichiganRegistered nurse (RN) · Michigan Medicaid (fee-for-service) | $18.08since 2024-10-01 | 15 min | $72.32 | Paid by the state, outside plans | — | MDHHS Private Duty Nursing Reimbursement |
| OhioRegistered nurse (RN) · Ohio Medicaid (fee-for-service) | $17.25since 2024-01-01 | 15 min | $69.00 | Plans negotiate; applies out of network | — | OAC 5160-12-06 Appendix A (ODM private d |
| WashingtonRegistered nurse (RN) · Washington Apple Health (Medicaid) fee-for-service | $16.97since 2025-01-01 | 15 min | $67.88 | Plans must pay at least this | — | HCA Private duty nursing fee schedule (p |
| District of ColumbiaAny qualified provider (rate does not vary by provider) · DC Medicaid (DHCF) fee-for-service | $16.15since 2026-10-01 | 15 min | $64.60 | Not classified | — | REFRP00178CSV - Medical Fee Schedule Rep |
| OregonRegistered nurse (RN) · Oregon Health Plan (fee-for-service, OHA) | $15.49since 2023-07-01 | 15 min | $61.96 | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| MissouriNurse (RN or LPN, same rate) · Missouri Medically Complex Adult Waiver (1915(c)) | $15.20since 2024-07-01 | 15 min | $60.80 | Paid by the state, outside plans | — | MO HealthNet fee schedule: Medically Com |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $15.00since 2024-01-01 | 15 min | $60.00 | Plans negotiate; applies out of network | — | KY Medicaid PDN fee schedule (2024-Priva |
| IdahoRegistered nurse (RN) · Idaho Adults with Developmental Disabilities 1915(c) Waiver (ID.0076) | $14.68since 2026-07-01 | 15 min | $58.72 | Paid by the state, outside plans | — | Adult Developmental Disabilities Waiver |
| North CarolinaRegistered nurse (RN) · North Carolina Medicaid Direct (fee-for-service) | $13.00since 2025-10-01 | 15 min. | $52.00 | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Private Duty N |
| NebraskaRegistered nurse (RN) · Nebraska Medicaid (fee-for-service) | $11.23since 2026-07-01 | unit | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $11.02since 2026-04-01 | 15 min | $44.08 | Plans negotiate; applies out of network | — | Fee Schedule - Private Duty Nursing (Eff |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $10.45since 2025-07-01 | 15 min | $41.80 | Not classified | — | Montana Healthcare Programs fee schedule |
| TexasRegistered nurse (RN) · Texas Medicaid (fee-for-service, TMHP) | $10.22since 2023-09-01 | 15 min | $40.88 | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Thste |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $10.00since 2024-01-01 | 15 min | $40.00 | Plans must pay at least this | — | SoonerCare Title XIX Fee Schedule |
| MaineRegistered nurse (RN) · MaineCare (fee-for-service) | $9.06since 2026-01-01 | 15 min | $36.24 | Not classified | — | MaineCare Section 96 Private Duty Nursin |
| FloridaRegistered nurse (RN) · Florida iBudget waiver for people with developmental disabilities (APD) | $8.16since 2026-07-01 | 15 min | $32.64 | Paid by the state, outside plans | — | Florida Medicaid Developmental Disabilit |
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 T1000?
It depends on the state. Of the 22 states with a published fee-for-service rate, the median is $15.35. South Carolina pays the most ($140.80 per 15 min) and Florida the least ($8.16 per 15 min).
Which state pays the highest Medicaid rate for T1000?
South Carolina, at $140.80 per 15 min ($563.20 per hour), effective 2017-07-01.
Do managed-care plans pay the same rate for T1000?
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.
Related Private duty nursing codes
T1002Rn services, up to 15 minutes · 43 statesT1003Lpn/lvn services, up to 15 minutes · 37 statesS9123Nursing care, in the home; by registered nurse, per hour · 31 statesT1004Services of a qualified nursing aide, up to 15 minutes · 19 statesG2252Waiver nursing (RN or LPN, by the 15 minutes) · 17 statesG2251Waiver nursing (RN or LPN, by the 15 minutes) · 16 statesG2250Waiver nursing (RN or LPN, by the 15 minutes) · 14 statesS5108Home care training to home care client, per 15 minutes · 10 statesS5115Home care training, non-family; per 15 minutes · 9 statesS5110Home care training, family; per 15 minutes · 8 statesG2215Waiver nursing (RN or LPN, by the 15 minutes) · 6 states
Track T1000 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.