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T1002 Medicaid reimbursement rates by state

Rn services, up to 15 minutes. 20 state Medicaid programs publish a fee-for-service rate for T1002 at the rn level. Rates run from $5.61 in Nebraska to $3,510.00 in New Jersey, with a median of $17.98.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
20
Median rate
$17.98units vary by state
Highest
$3,510.00New Jersey
Medicare (non-facility)
—not on the physician fee schedule

T1002 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.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
New JerseyRegistered nurse (RN) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$3,510.00⚠ over 3× mediansince 2025-12-0115 min$14,040.00Plans must pay at least this—NJMMIS Procedure Master Listing CPTHCPCS
IllinoisRegistered nurse (RN) · Illinois Persons with Brain Injury waiver (DHS-DRS Home Services Program, IL.0329)$54.38since 2026-07-01hour$54.38Plans must pay at least this—HSP Rates and Fees (Medicaid Waiver Serv
GeorgiaRegistered nurse (RN) · Georgia New Options Waiver (NOW) for people with IDD$36.68since 2025-04-0115 min$146.72Paid by the state, outside plans—New Options Waiver Program-Q2-April 2025
OhioRegistered nurse (RN) · Ohio Medicaid (fee-for-service)$35.99since 2024-01-0115 min$143.96Plans expected to pay at least this—OAC 5160-27-03 Appendix A, Community Beh
MassachusettsRegistered nurse (RN) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$33.12since 2024-08-0115 min$132.48Paid by the state, outside plans—Rates for Continuous Skilled Nursing Age
VirginiaRegistered nurse (RN) · Virginia Medicaid (fee-for-service, DMAS)$22.73since 2026-07-0115 min$90.92Paid by the state, outside plans—DMAS procedure fee file hcpcmedical.csv
WisconsinRegistered nurse (RN) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$20.48since 2004-01-0115 min$81.92Paid by the state, outside plans—ForwardHealth max fee schedule: School B
MissouriRegistered nurse (RN) · Missouri DD Community Support Waiver (DMH Division of DD, 1915(c))$20.29since 2022-07-0115 min$81.16Paid by the state, outside plans—MO HealthNet fee schedule: Community Sup
MarylandRegistered nurse (RN) · Maryland Medicaid (fee-for-service, MDH)$19.87since 2024-07-0115 min$79.50Not classified—PT 07-25 Fiscal Year 2025 Rates for Nurs
ArizonaRegistered nurse (RN) · Arizona AHCCCS behavioral health outpatient MCO capped fee schedule$19.40since 2021-02-0115 min$77.60Suggested schedule for plans—AHCCCS MCO Behavioral Health Outpatient
PennsylvaniaRegistered nurse (RN) · Pennsylvania OBRA Waiver (adults with developmental physical disabilities)$16.55since 2026-07-0115 min$66.20Not classified—OLTL Home and Community Based Waiver Ser
MinnesotaRegistered nurse (RN) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$13.26since 2026-01-0115 min$53.04Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
WashingtonRegistered nurse (RN) · Washington ALTSA nursing services (nurse delegation, private duty nursing for adults)$12.86since 2025-07-01OF—Paid by the state, outside plans—DSHS ORM Home & Community Based Rates Hi
South CarolinaRegistered nurse (RN) · South Carolina Intellectual Disability and Related Disabilities (ID/RD) Waiver (SC.0237, DDSN-operated)$12.50since 2025-11-0115 min$50.00Paid by the state, outside plans—SCDHHS HCBS Waivers Fee Schedule (Effect
CaliforniaRegistered nurse (RN) · California Medi-Cal school-based services (Local Educational Agency)$12.08since 2026-10-0115 min$48.32Paid by the state, outside plans—Medi-Cal Rates (Rates files zip: rates_d
TexasRegistered nurse (RN) · Texas Medicaid (fee-for-service, TMHP)$10.50since 2014-01-0115 min$42.00Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Tuber
North CarolinaRegistered nurse (RN) · North Carolina Medicaid Direct (fee-for-service)$8.72since 2025-10-0115 min$34.88Plans negotiate; applies out of network—NC Medicaid fee schedule 'Home Infusion
LouisianaRegistered nurse (RN) · Louisiana New Opportunities Waiver (NOW, OCDD/OIDD 1915(c) waiver for people with intellectual/developmental disabilities)$8.55since 2026-10-0115 min$34.20Paid by the state, outside plans—New Opportunities Waiver rate and proced
FloridaRegistered nurse (RN) · Florida iBudget waiver for people with developmental disabilities (APD)$8.16since 2026-07-0115 min$32.64Paid by the state, outside plans—Florida Medicaid Developmental Disabilit
NebraskaRegistered nurse (RN) · Nebraska Medicaid (fee-for-service)$5.61since 2026-07-01unit—Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5

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 T1002?

It depends on the state. Of the 20 states with a published fee-for-service rate, the median is $17.98. New Jersey pays the most ($3,510.00 per 15 min) and Nebraska the least ($5.61 per unit).

Which state pays the highest Medicaid rate for T1002?

New Jersey, at $3,510.00 per 15 min ($14,040.00 per hour), effective 2025-12-01.

Do managed-care plans pay the same rate for T1002?

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

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