Billing code T5999 · Other home & community services

T5999 Medicaid reimbursement rate by state (2026)

Supply, not otherwise specified. Medicaid pays a median of $10.00 for T5999 across 11 states, from $0.56 in Hawaii to $3,000.00 in North Dakota.

Data as of Oct 5, 202611 statesEvery rate links to its official source

Compare T5999 in all 11 states All billing codes

States publishing: 11
National median: $10.00units vary by state
Lowest: $0.56Hawaii
Highest: $3,000.00North Dakota

Answer

What does Medicaid pay for T5999?

11 state Medicaid programs publish a fee-for-service rate for T5999. The national median is $10.00 (units differ between states). North Dakota pays the most, $3,000.00 per Per Item, and Hawaii the least, $0.56, a 5357.1x spread.

State ranking

T5999 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 11 states with every variant, modifier and effective date.

#	State	Medicaid rate	Unit	Per hour	Managed-care plans	% of Medicare
1	North Dakota Source · since 2026-07-01	$3,000.00	Per Item	—	Not classified	—
2	Mississippi Source · since 2012-01-01	$2,000.00	—	—	Paid by the state, outside plans	—
3	Minnesota Source · since 2026-01-01	$800.00	Decremental	—	Paid by the state, outside plans	—
···
5	Iowa Source · since 2024-07-01	$25.11	—	—	State sets the plan rate	—
6	Ohio Source · since 2016-06-06	$10.00	Each	—	Plans negotiate; applies out of network	—
···
10	New York Source · since 2022-06-01	$3.00	—	—	Plans negotiate; applies out of network	—
11	Hawaii Source · since 2024-03-04	$0.56	—	—	Plans negotiate; applies out of network	—

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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; states with several Medicare localities show a range. Confirm rates with the payer before billing.

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FAQ

Frequently asked questions

What does Medicaid pay for T5999?

It depends on the state. Of the 11 states with a published fee-for-service rate, the median is $10.00. North Dakota pays the most ($3,000.00 per Per Item) and Hawaii the least ($0.56).

Which state pays the highest Medicaid rate for T5999?

North Dakota, at $3,000.00 per Per Item, effective 2026-07-01.

Do managed-care plans pay the same rate for T5999?

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 workspace shows the rule for each state, cited to the contract or statute.

T5999 Medicaid reimbursement rate by state (2026)

What does Medicaid pay for T5999?

T5999 rate by state: highest, middle and lowest

Frequently asked questions

Related codes and states

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