T1005 Medicaid reimbursement rates by state
Respite care services, up to 15 minutes. 34 state Medicaid programs publish a fee-for-service rate for T1005 at the agency level. Rates run from $0.56 in Arkansas to $290.45 in New Jersey, with a median of $6.10.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 34
- Median rate
- $6.10units vary by state
- Highest
- $290.45New Jersey
- Medicare (non-facility)
- —not on the physician fee schedule
T1005 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) | $290.45⚠ over 3× mediansince 2026-01-01 | 15 min | $1,161.80 | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| UtahAny qualified provider (rate does not vary by provider) · Utah Technology Dependent 1915(c) waiver | $35.00⚠ over 3× mediansince 2026-07-01 | 15 min | $140.00 | Paid by the state, outside plans | — | Utah Medicaid Coverage and Reimbursement |
| DelawareAgency provider · Delaware DDDS Lifespan 1915(c) HCBS waiver | $29.51since 2024-07-01 | hour | $29.51 | Paid by the state, outside plans | — | DDDS Medicaid HCBS 1915(c) Lifespan Waiv |
| IllinoisAgency provider · Illinois Persons with Brain Injury waiver (DHS-DRS Home Services Program, IL.0329) | $25.00since 2026-07-01 | hour | $25.00 | Plans must pay at least this | — | HSP Rates and Fees (Medicaid Waiver Serv |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia developmental disability waivers (Building Independence, Family and Individual Supports, Community Living) | $20.23since 2025-07-01 | hour | $20.23 | Paid by the state, outside plans | — | DMAS Developmental Disabilities Waiver S |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Child Mental Health Wraparound (CMHW) services | $14.53since 2023-12-07 | 15 min | $58.12 | Paid by the state, outside plans | — | IHCP Professional Fee Schedule (Last Upd |
| North CarolinaNurse (RN or LPN, same rate) · North Carolina Community Alternatives Program for Children (CAP/C) | $13.00since 2025-10-01 | 15 min | $52.00 | Paid by the state, outside plans | — | NC Medicaid fee schedule 'CAP for Childr |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $12.85since 2026-02-01 | 15 min | $51.40 | Not classified | — | Vermont Medicaid Fee Schedule - HCPCS (i |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Assistive Daily Living Services (ADLS) Waiver (1915(c)) | $10.81since 2026-07-01 | 15 min | $43.24 | Not classified | — | South Dakota Medicaid Assistive Daily Li |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri DD Community Support Waiver (DMH Division of DD, 1915(c)) | $10.34since 2024-07-01 | 15 min | $41.36 | Paid by the state, outside plans | — | MO HealthNet fee schedule: Community Sup |
| WashingtonAgency provider · Washington ALTSA in-home personal care (home care agency) | $9.97since 2024-01-01 | 1/4 HR | — | Paid by the state, outside plans | — | DSHS ORM Home & Community Based Rates Hi |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi HCBS Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) 1915(c) waiver | $8.74since 2026-01-01 | 15 min | $34.96 | Paid by the state, outside plans | — | MS DOM TBI/SCI Waiver fee schedule (Copy |
| ColoradoAide or attendant (HHA, CNA, PCA, home care aide) · Colorado HCBS waiver for children with a life-limiting illness (CLLI) | $8.34since 2023-07-01 | 15 min | $33.36 | Paid by the state, outside plans | — | CLLI, CHCBS, CHRP (effective January 1, |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Developmental Disabilities 1915(c) Waiver (NM.0173) | $7.46since 2026-07-01 | 15 min | $29.84 | Paid by the state, outside plans | — | Developmental Disabilities Waiver Fee Sc |
| AlabamaAny qualified provider (rate does not vary by provider) · Alabama Intellectual Disabilities (ID) 1915(c) waiver (AL.0001; ADMH-DDD operated) | $7.15since 2024-01-05 | 15 min | $28.60 | Not classified | — | ADMH-DDD ID / LAH Waiver Procedure Codes |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Intellectual Disability and Related Disabilities (ID/RD) Waiver (SC.0237, DDSN-operated) | $6.25since 2025-11-01 | 15 min | $25.00 | Paid by the state, outside plans | — | SCDHHS HCBS Waivers Fee Schedule (Effect |
| MontanaAny qualified provider (rate does not vary by provider) · Montana HCBS waiver for adults with severe disabling mental illness (1915(c), fee-for-service) | $6.20since 2025-07-01 | 15 min | $24.80 | Not classified | — | Montana Medicaid Fee Schedule - HCBS for |
| KentuckyAgency provider · Kentucky Acquired Brain Injury Long Term Care 1915(c) waiver | $6.00since 2025-01-01 | 15 min | $24.00 | Paid by the state, outside plans | — | DMS 1915(c) HCBS LTSS RISE Services Summ |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma ADvantage 1915(c) waiver (older adults and adults with physical disabilities) | $5.79since 2024-10-01 | 15 min | $23.16 | Paid by the state, outside plans | — | Reimbursement Rates for Services, ADvant |
| 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) | $5.52since 2024-07-01 | 15 min | $22.08 | Paid by the state, outside plans | — | FY2025 PBHS Fee Schedule – PRP and Speci |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Children with Serious Emotional Disorder 1915(c) Waiver (CSEDW) | $5.01since 2024-10-01 | 15 min | $20.04 | Plans must pay at least this | — | Children with Serious Emotional Disorder |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island developmental disabilities services (BHDDH, paid fee-for-service under the 1115 waiver) | $4.78since 2026-10-01 | 15 min | $19.12 | Paid by the state, outside plans | — | RI Medicaid Interactive Fee For Service |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare Home and Community Benefits for the Elderly and Adults with Disabilities (MBM Section 19 waiver, fee-for-service) | $4.73since 2026-01-01 | 15 Minutes - Cost not to exceed Cap | — | Not classified | — | MaineCare Section 19 Elderly and Adults |
| FloridaLicensed practical / vocational nurse (LPN / LVN) · Florida iBudget waiver for people with developmental disabilities (APD) | $4.72since 2026-07-01 | 15 min | $18.88 | Paid by the state, outside plans | — | Florida Medicaid Developmental Disabilit |
| WyomingAgency provider · Wyoming DD waivers (Comprehensive and Supports, 1915(c)) | $4.68since 2026-07-22 | 15 min | $18.72 | Not classified | — | DD Waiver Fee Schedule - Effective July |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Developmental Disabilities 1915(c) waiver | $4.67since 2024-01-01 | 15 min | $18.68 | Paid by the state, outside plans | — | 2024 Fee Schedule - DD Waiver Fee Schedu |
| PennsylvaniaAgency provider · Pennsylvania Act 150 attendant care program (state-funded) | $4.49since 2026-07-01 | 15 min | $17.96 | Not classified | — | OLTL Home and Community Based Waiver Ser |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Community Choices Waiver (OAAS 1915(c) waiver for older adults and adults with disabilities) | $4.02since 2026-10-01 | 15 min | $16.08 | Paid by the state, outside plans | — | Community Choices Waiver services proced |
| IowaAgency provider · Iowa HCBS AIDS/HIV 1915(c) waiver | $3.94since 2025-08-01 | 15 min | $15.76 | Not classified | — | HCBS Habilitation and Waiver Upper Rate |
| IdahoAgency provider · Idaho Children's DD 1915(i) State Plan HCBS (support and family-directed services) | $3.51since 2025-09-01 | 15 min | $14.04 | Paid by the state, outside plans | — | Children's DDA Fee Schedule |
| WisconsinAgency provider · Wisconsin Children's Long-Term Support (CLTS) Waiver (fee-for-service, statewide uniform rate schedule) | $3.50since 2025-01-01 | 15-min. | — | Paid by the state, outside plans | — | CLTS Waiver Statewide Uniform Rate Sched |
| TexasAgency provider · Texas Home and Community-Based Services - Adult Mental Health (HCBS-AMH, 1915(i)) | $3.40since 2025-09-01 | 15 min | $13.60 | Not classified | — | HHSC PFD HCBS-AMH payment rates (9-1-202 |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $2.63since 2026-10-01 | 15 min | $10.52 | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas ARChoices in Homecare 1915(c) waiver | $0.56since 2022-08-25 | 15 min | $2.24 | Paid by the state, outside plans | — | Arkansas Medicaid ARChoices Fee Schedule |
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 T1005?
It depends on the state. Of the 34 states with a published fee-for-service rate, the median is $6.10. New Jersey pays the most ($290.45 per 15 min) and Arkansas the least ($0.56 per 15 min).
Which state pays the highest Medicaid rate for T1005?
New Jersey, at $290.45 per 15 min ($1,161.80 per hour), effective 2026-01-01.
Do managed-care plans pay the same rate for T1005?
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 Other home & community services codes
96158Positive behavioral interventions and support · 38 statesT1016Case management, each 15 minutes · 35 statesT1017Targeted case management, each 15 minutes · 35 statesT1001Nursing assessment / evaluation · 33 statesS5125Attendant care services; per 15 minutes · 32 statesS5170Home delivered meals, including preparation; per meal · 32 statesT2025Waiver services; not otherwise specified (nos) · 30 statesS5150Unskilled respite care, not hospice; per 15 minutes · 29 statesS5161Emergency response system; service fee, per month · 27 statesG0101Respite care (daily) · 26 statesT2022Case management, per month · 26 statesS5160Emergency response system; installation and testing · 25 states
Track T1005 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.