Behavioral health Medicaid rates in Idaho hold both a national floor and a national high. Idaho Medicaid pays $2.15 per 15 minutes for code H2014 skills training, or $8.60 an hour, the lowest of 33 states and 83.2% below the $51.20 national median. Yet for therapeutic behavioral services on code H0036, Idaho pays $142.44 an hour, 4th of 28 states and 62.2% above the median.
Which code a service falls under decides whether an Idaho program loses or makes money. That makes Idaho one of the clearest examples in the country of why a provider has to read a state's schedule code by code rather than judging it by a single headline rate.
Idaho bills H2014 with modifier EP at $2.15 per 15 minutes, effective September 1, 2025. At $8.60 an hour, it sits below Pennsylvania ($10.00) and Florida ($13.40), the other two lowest states. The top-paying states for skills training are Rhode Island ($139.64), Iowa ($120.60) and Delaware ($119.68).
The wage data makes the gap concrete. The Idaho median psychiatric technician wage is $19.95 an hour, which is 329.7% of the $8.60 hourly rate. The margin after a loaded wage is negative on every hour, at -$19.75. An Idaho agency cannot fund skills training from this Medicaid rate alone.
The September 1, 2025 effective date lines up with Idaho's 4% provider rate reductions, which are listed among the state's source documents as projected rates from that date. A code already near the bottom of the national range lost further ground with that reduction.
Idaho's therapeutic behavioral services rate tells the opposite story. It bills H0036 with modifiers U5, UD and GT at $35.61 per 15 minutes, $142.44 an hour, effective November 1, 2025. Only Maine ($449.72), Wyoming ($149.80) and Washington ($145.40) pay more; Ohio ($128.96) is just behind.
Against the same $19.95 technician wage, the wage share is 19.9% of the rate and the margin after a loaded wage is $114.09 an hour. That is a wide margin for a paraprofessional service.
Why the modifiers matter
The H0036 rate is tied to a specific modifier combination. In Idaho, modifiers identify the delivery mode, the program and the practitioner type, and the same base code can carry a different rate under a different combination. Before quoting this rate in a budget, confirm that your service, setting and staff level match the modifiers on the rate line. The full list of H0036 and H2014 variants is in the Idaho dataset.
The distance between H2014 and H0036 is not a pricing accident; it reflects how Idaho defines each service. Skills training is priced as a low-intensity, high-volume support. Therapeutic behavioral services, under the modifiers above, is priced as a more intensive intervention.
For an Idaho provider, the operational question is whether a client's needs and the service definition support billing H0036 rather than H2014. That is a clinical and documentation question, not a billing choice: the treatment plan, the staff credential and the setting must all fit the definition. Programs that deliver both services should track them as separate business lines, because blending them hides a loss on one and overstates the margin on the other.
| Service | Code | Idaho rate | Rank | vs national median |
|---|---|---|---|---|
| Therapeutic behavioral services (hour) | H0036 | $142.44 | 4 of 28 | +62.2% |
| Outpatient psychotherapy and evaluation | 90880 | $87.37 | 10 of 28 | +4.8% |
| Service plan development | H0032 | $14.82 | 16 of 18 | -51.1% |
| Skills training (hour) | H2014 | $8.60 | 33 of 33 | -83.2% |
- Psychotherapy. Idaho's reference rate is $87.37 on code 90880, effective July 1, 2026, a little above the $83.33 median. The July 2026 date means Idaho's therapy rates are among the most recently updated in the country.
- Service planning. H0032 with modifiers GT and UB pays $14.82, effective April 13, 2026. Idaho is one of the three lowest states, with New Jersey ($13.67) and Louisiana ($10.00). Maryland leads at $131.35.
- Assessment. Idaho pays $20.56 per 15 minutes on H0031 with modifiers U1 and GT, $82.24 an hour, effective November 1, 2025. It is not ranked nationally; the national median for a non-physician assessment is $125.00 per published unit.
Read together, these four lines describe a schedule that rewards clinical and intensive services and underpays supportive and planning work. Therapy and therapeutic behavioral services sit above the national median; planning and skills training sit near the bottom. A program that leans on licensed therapy and H0036 will find Idaho Medicaid one of the better-paying states in the Mountain West, while a program built around skills groups and case planning will struggle to cover staff time.
That pattern also shapes hiring. Idaho providers tend to get the best return from clinicians who can deliver the higher-paying services directly, and from technicians whose time is billed under H0036 rather than H2014 where the service definition allows it.
Federal occupational wage data for May 2025 shows Idaho wages near or below the national median for most roles.
- Mental health counselor: $30.46 in Idaho, $28.53 nationally
- Mental health social worker: $25.25 in Idaho, $28.98 nationally
- Clinical psychologist: $47.01 in Idaho, $48.36 nationally
- Nurse practitioner: $63.72 in Idaho, $63.61 nationally
- Psychiatric technician: $19.95 in Idaho, $21.70 nationally
Counselors are the one licensed role that costs more in Idaho than nationally, so a therapy practice staffed by social workers has an edge against the near-median psychotherapy rate. For community programs, the technician wage is below the national median, which helps H0036 margins but cannot rescue H2014.
Outpatient behavioral health in Idaho runs through the Idaho Behavioral Health Plan, a statewide behavioral health plan. Magellan of Idaho has administered it since July 1, 2024, after Optum Idaho. Its outpatient provider rates are published in a revision log, most recently updated July 1, 2026. The plan carries 1,616 current rates in our records, and Idaho's behavioral health line holds 1,200 rates in all, one of the deepest behavioral health schedules we track.
Our records do not include a specific managed-care pricing rule for Idaho's behavioral health line, so providers should check the Magellan outpatient rate log alongside the Idaho Medicaid fee schedule. A December 2025 information release (MA25-20) set out which behavioral health claims route to the state's fee-for-service system and which go to Magellan. Getting that routing right is the first step to being paid at all.
Medical managed care in Idaho includes Molina Healthcare of Idaho and UnitedHealthcare Community Plan of Idaho for dual-eligible members. We track 7 plans in the state; the Idaho managed care page lists them.
On coverage, none of the psychotherapy codes we track in Idaho carries a prior-authorization rule or a published unit limit. That includes the diagnostic evaluation 90791, the session codes through 90837, crisis codes and family and group therapy.
For an outpatient practice, that is a meaningful administrative advantage. Without authorization requirements, intake can move straight to treatment, and revenue depends on documentation and medical necessity rather than on approval timing. The absence of a published limit does not remove medical-necessity review, so session notes still need to support the frequency billed.
- Behavioral health respite. Information release MA26-20 updated behavioral health respite services, effective September 8, 2026.
- Magellan outpatient rates. The IBHP outpatient rate revision log was updated July 1, 2026.
- ACT and peer support. Information release MA26-09, effective April 3, 2026, set reimbursement for Assertive Community Treatment and mental health peer support for adults.
- Claims routing. Information release MA25-20 clarified Gainwell versus Magellan routing for behavioral health claims.
The ACT and peer support release matters most for community providers, since it brings two team-based adult services into a defined payment structure. Programs considering ACT should model it separately from H0036 and H2014.
Idaho is the floor of the country on skills training and near the top on therapeutic behavioral services. Compare with Rhode Island, the top H2014 payer, Maine, the top for therapeutic behavioral services, and Pennsylvania, next to Idaho at the bottom. Among neighbors, Montana and Utah publish their own behavioral health schedules with different code structures.
- Separate the business lines. Budget H0036, H2014, therapy and assessment as distinct services with their own revenue per staff hour.
- Confirm the rate line. Match each service to the exact modifier combination before relying on a rate.
- Check the payer. Use MA25-20 to confirm whether a claim goes to Magellan or to fee-for-service.
- Watch reductions. The 4% reductions from September 2025 show Idaho will cut rates; re-check each quarterly fee schedule version.
Rates on this page are compiled from official Idaho Medicaid publications, and each rate on our site links to its source document. Idaho's sources include the Idaho Medicaid Numerical Fee Schedule July to September 2026 (Version 1.4), the Magellan Idaho Behavioral Health Plan Rates effective November 1, 2025 and April 13, 2026, and the Idaho Medicaid 4% Provider Rate Reductions Fee Schedules. Our methodology explains how hourly rates and ranks are calculated.
All 23,716 current Idaho Medicaid rates, across 116 service categories and history back to 2008, are on the Idaho Medicaid rates page. National medians are on the behavioral health Medicaid rates by state hub.