T1028 Medicaid reimbursement rates by state
Assessment of home, physical and family environment. 16 state Medicaid programs publish a fee-for-service rate for T1028 at the technician level. Rates run from $7.69 in New Jersey to $628.00 in Indiana, with a median of $120.50.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 16
- Median rate
- $120.50units vary by state
- Highest
- $628.00Indiana
- Medicare (non-facility)
- —not on the physician fee schedule
T1028 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 |
|---|---|---|---|---|---|---|
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Community Integration and Habilitation (CIH) Waiver for people with IDD | $628.00since 2024-07-01 | unit | — | Paid by the state, outside plans | — | IHCP Professional Fee Schedule (Last Upd |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana New Opportunities Waiver (NOW, OCDD/OIDD 1915(c) waiver for people with intellectual/developmental disabilities) | $450.00since 2025-11-18 | One time | — | Paid by the state, outside plans | — | New Opportunities Waiver rate and proced |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $266.62since 2026-10-05 | — | — | Paid by the state, outside plans | — | Emergency Adoption (date filed: Septembe |
| AlabamaBehavior technician (RBT / BT) · Alabama Intellectual Disabilities (ID) 1915(c) waiver (AL.0001; ADMH-DDD operated) | $250.00since 2024-01-05 | Install | — | Not classified | — | ADMH-DDD ID / LAH Waiver Procedure Codes |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $161.82since 2024-07-01 | — | — | 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) | $160.00since 2014-11-06 | — | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $125.00since 2022-07-01 | — | — | Plans negotiate; applies out of network | — | MO HealthNet fee schedule: Department of |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Acquired Brain Injury (ABI, acute) 1915(c) waiver | $121.00since 2025-01-01 | Per Assessment | — | Paid by the state, outside plans | — | DMS Home and Community Based Services Wa |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $120.00since 2019-02-01 | — | — | Not classified | — | Vermont Medicaid Fee Schedule - HCPCS (i |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service) | $90.76since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | RI Medicaid Interactive Fee For Service |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Birth to Three (early intervention) Medicaid billing | $35.50since 2026-07-01 | — | — | Not classified | — | CMAP fee schedule: 7/1/2026 Birth to Thr |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $26.66since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota HOPE Waiver (1915(c) elderly and adults with physical disabilities; DHS Long Term Services and Supports) | $21.32since 2026-07-01 | 15 min | $85.28 | Not classified | — | South Dakota Medicaid HOPE Waiver Fee Sc |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid School-Based Services (billed by school districts) | $9.94since 2025-07-01 | 15 min | $39.76 | Not classified | — | School Based Services Fee Schedule 2025. |
| WashingtonRegistered nurse (RN) · Washington DDA waiver and state plan services (Basic Plus, Core, IFS, CIIBS, CP) | $8.24since 2020-07-01 | OF | — | Paid by the state, outside plans | — | DSHS ORM All DDA Rates |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $7.69since 2025-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
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 T1028?
It depends on the state. Of the 16 states with a published fee-for-service rate, the median is $120.50. Indiana pays the most ($628.00 per unit) and New Jersey the least ($7.69).
Which state pays the highest Medicaid rate for T1028?
Indiana, at $628.00 per unit, effective 2024-07-01.
Do managed-care plans pay the same rate for T1028?
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 statesT1005Respite care services, up to 15 minutes · 34 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 states
Track T1028 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.