T1020 Medicaid reimbursement rates by state
Personal care services, per diem. 20 state Medicaid programs publish a fee-for-service rate for T1020 at the aide level. Rates run from $3.00 in Virginia to $3,500.00 in South Dakota, with a median of $75.88.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 20
- Median rate
- $75.88units vary by state
- Highest
- $3,500.00South Dakota
- Medicare (non-facility)
- —not on the physician fee schedule
T1020 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 DakotaAny qualified provider (rate does not vary by provider) · South Dakota Family Support 360 Waiver (1915(c) developmental disabilities, in-home supports) | $3,500.00since 2025-07-01 | month | — | Not classified | — | South Dakota Medicaid Family Support 360 |
| IllinoisAide or attendant (HHA, CNA, PCA, home care aide) · Illinois Medically Fragile, Technology Dependent waiver (IL.0278) and EPSDT in-home nursing, operated by UIC-DSCC | $1,300.00since 2025-01-01 | Client Day | — | Not classified | — | Medically Fragile Technology Dependent ( |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $517.55⚠ over 3× mediansince 2025-01-01 | day | — | Paid by the state, outside plans | — | OHP FFS behavioral health fee schedule ( |
| VermontAide or attendant (HHA, CNA, PCA, home care aide) · Vermont Brain Injury Program (TBI; DAIL ASD), Rehab/Long Term (U8) and Mental Health Funded (HI/UD) | $379.40since 2025-07-01 | 1 day | — | Not classified | — | DAIL Adult Services Division - Billing C |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Developmental Disabilities 1915(c) waiver | $295.72⚠ over 3× mediansince 2024-01-01 | day | — | Paid by the state, outside plans | — | 2024 Fee Schedule - DD Waiver Fee Schedu |
| IowaAgency provider · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $294.00⚠ over 3× mediansince 2012-06-11 | day | — | Paid by the state, outside plans | — | Iowa Medicaid fee schedule #56 LOCAL EDU |
| ArizonaAide or attendant (HHA, CNA, PCA, home care aide) · Arizona AHCCCS behavioral health outpatient MCO capped fee schedule | $264.72since 2026-10-01 | — | — | Suggested schedule for plans | — | AHCCCS MCO Fee Schedule Final MCO Behavi |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $174.31since 2026-07-01 | day | — | Not classified | — | MaineCare Section 97 PNMI Appendix E Men |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma Developmental Disabilities Services 1915(c) waivers (Community, In-Home Supports adults and children, Homeward Bound) | $155.16since 2024-10-01 | day | — | Paid by the state, outside plans | — | DDS Administrative Letter 24-02: Rate In |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi HCBS Assisted Living 1915(c) waiver | $82.78since 2026-01-01 | day | — | Paid by the state, outside plans | — | MS DOM Assisted Living Waiver fee schedu |
| GeorgiaAide or attendant (HHA, CNA, PCA, home care aide) · Georgia Elderly and Disabled Waiver (CCSP and SOURCE) | $68.97since 2024-07-01 | day | — | Paid by the state, outside plans | — | Part II Policies and Procedures: EDWP - |
| District of ColumbiaAide or attendant (HHA, CNA, PCA, home care aide) · DC Medicaid (DHCF) fee-for-service | $65.00since 2016-08-01 | day | — | Not classified | — | REFRP00178CSV - Medical Fee Schedule Rep |
| IndianaAide or attendant (HHA, CNA, PCA, home care aide) · Indiana Family Supports Waiver (FSW) for people with IDD | $38.36since 2023-07-01 | hour | $38.36 | Paid by the state, outside plans | — | IHCP Professional Fee Schedule (Last Upd |
| UtahAide or attendant (HHA, CNA, PCA, home care aide) · Utah Medicaid (fee-for-service, Traditional plan) | $33.23since 2003-10-01 | day | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| ArkansasAide or attendant (HHA, CNA, PCA, home care aide) · Arkansas Medicaid (fee-for-service) | $28.24since 2021-01-01 | day | — | Not classified | — | Arkansas Medicaid Personal Care Services |
| WashingtonAide or attendant (HHA, CNA, PCA, home care aide) · Washington Apple Health (Medicaid) fee-for-service | $21.80since 2021-01-01 | day | — | Plans negotiate; applies out of network | — | HCA Physician-related services fee sched |
| MontanaAide or attendant (HHA, CNA, PCA, home care aide) · Montana Big Sky Waiver for elderly and physically disabled adults (1915(c), fee-for-service) | $15.80since 2025-07-01 | day | — | Not classified | — | Montana Healthcare Programs fee schedule |
| FloridaAide or attendant (HHA, CNA, PCA, home care aide) · Florida Medicaid (fee-for-service) | $15.58since 2026-01-01 | day | — | Plans negotiate; applies out of network | — | Assistive Care Services Fee Schedule (Up |
| North DakotaAide or attendant (HHA, CNA, PCA, home care aide) · North Dakota Medicaid (fee-for-service) | $6.98since 2026-07-01 | day | — | Not classified | — | QSP Rates and Rural Differential Rate (C |
| VirginiaAide or attendant (HHA, CNA, PCA, home care aide) · Virginia Medicaid (fee-for-service, DMAS) | $3.00since 2022-07-01 | day | — | Plans must pay at least this | — | DMAS procedure fee file hcpcmedical.csv |
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 T1020?
It depends on the state. Of the 20 states with a published fee-for-service rate, the median is $75.88. South Dakota pays the most ($3,500.00 per month) and Virginia the least ($3.00 per day).
Which state pays the highest Medicaid rate for T1020?
South Dakota, at $3,500.00 per month, effective 2025-07-01.
Do managed-care plans pay the same rate for T1020?
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 · 40 statesT1017Targeted case management, each 15 minutes · 37 statesT1016Case management, each 15 minutes · 36 statesT1001Nursing assessment / evaluation · 35 statesT1005Respite care services, up to 15 minutes · 35 statesS5125Attendant care services; per 15 minutes · 34 statesS5170Home delivered meals, including preparation; per meal · 34 statesT2025Waiver services; not otherwise specified (nos) · 31 statesS5150Unskilled respite care, not hospice; per 15 minutes · 30 statesS5161Emergency response system; service fee, per month · 29 statesT2022Case management, per month · 28 statesG0101Respite care (daily) · 27 states
Track T1020 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.