Behavioral health Medicaid rates in New Hampshire are defined by stability more than by rank. New Hampshire Medicaid pays $27.38 for mental health counseling on code H0046, which ranks 6th of 12 states and sits 4.5% above the $26.19 national median. That rate has been in effect since 2023-07-01, and the state's crisis therapy rate dates to 2021-01-01.
The picture is uneven across service lines. Crisis psychotherapy time pays well relative to staff cost, while therapeutic behavioral services sit at half the national median, and most of New Hampshire's recent change activity is in substance use treatment rather than in outpatient mental health codes. Every rate here is compiled from official New Hampshire Medicaid publications, and each rate on the New Hampshire Medicaid rates hub links back to its source document.
| Service | Code | NH rate | Per hour | Rank |
|---|---|---|---|---|
| Mental health counseling | H0046 (TM) | $27.38 | n/a | 6 of 12 |
| Outpatient psychotherapy (crisis add-on) | 90840 | $89.19 per 30 min | $178.38 | not ranked |
| Therapeutic behavioral services | H2019 | $10.93 per 15 min | $43.72 | 21 of 28 |
| Community-based wraparound | H2022 | $126.18 a day | n/a | not ranked |
These four lines are the comparison rates we use to place New Hampshire against other states. They are not the whole schedule. The behavioral health line alone holds 371 current rates, and the full New Hampshire dataset covers all 26,581 current Medicaid rates across 111 service categories, each tied to the document that published it.
Each rate carries a set of modifiers. The H2019 line is billed with HQ, HW and U7, and the 90840 line with HW and U7, so providers should match modifiers exactly when comparing remittances with the published schedule. A claim billed without the right modifier combination can price at a different line or deny outright.
The H0046 rate of $27.38 puts New Hampshire in the middle of the 12 states ranked for mental health counseling. The highest states are South Dakota ($42.50), Wyoming ($42.34), the District of Columbia ($35.74) and Washington ($34.22). The lowest are Connecticut ($21.14), North Carolina ($18.49) and Michigan ($8.62).
Counseling has a narrow top end nationally, so a rank of 6th of 12 translates into a modest dollar difference. A New Hampshire practice is paid slightly better than a typical state on this code, but not enough for counseling volume alone to carry a growth plan.
What the counseling rank means in practice
Only 12 of the 31 states that publish a counseling rate can be ranked on a like-for-like basis, because states use different codes and units for the same service. A middle rank in a small, well-matched group is a more reliable signal than a middle rank in a large, mixed one. For New Hampshire providers, the practical reading is that H0046 is a dependable base rate that has not moved since mid-2023, so any cost growth since then has come out of margin.
New Hampshire's comparison rate for outpatient psychotherapy is code 90840, a crisis therapy add-on paid at $89.19 per 30 minutes, or $178.38 an hour. It is not ranked against other states because its unit differs from the session codes most states report.
The economics on this line are favorable. With a New Hampshire median counselor wage of $26.36 an hour, wages take 21.0% of the hourly rate, leaving $140.91 an hour after loaded wages. That margin applies to crisis add-on time, not routine weekly sessions, but it shows how the state values crisis response relative to staff cost.
For routine outpatient therapy, practices bill the standard psychotherapy codes such as 90837, which are listed on the state hub alongside every other current rate. The crisis add-on is best read as a premium on top of that routine work, and a practice that can staff same-day crisis capacity captures the strongest margin New Hampshire Medicaid offers in this industry.
The weakest New Hampshire rate is H2019. At $10.93 per 15 minutes, or $43.72 an hour, it ranks 21st of 28 and sits 50.2% below the $87.82 national median. Maine leads this service at $449.72 an hour, followed by Wyoming ($149.80) and Washington ($145.40).
The margin is thin. At a $21.47 median psychiatric technician wage, pay takes 69.8% of the hourly rate, leaving $13.20 an hour after loaded wages. For a community agency, that leaves little room for travel between home visits, documentation time or clinical supervision.
Why H2019 needs a program around it
Therapeutic behavioral services are usually delivered in homes, schools and community settings, which means unbillable time between visits. At $43.72 an hour, a New Hampshire agency cannot absorb much of that time. Agencies that run H2019 sustainably tend to cluster visits geographically, pair the service with higher-paid clinical lines, and track billable-hour ratios per staff member weekly rather than monthly. The rate effective since 2024-01-01 is the figure to plan against.
Wraparound is paid on a different basis. New Hampshire's comparison rate is $126.18 a day on H2022 with modifiers H9 and HU, effective 2023-07-01. Because it is a daily rate and most states pay wraparound by the hour, it is not ranked.
A daily rate changes how a provider should think about cost. Under an hourly rate, more hours of care mean more revenue. Under a daily rate, revenue is fixed per day of service and the provider's margin depends on how much staff time each day actually requires. Wraparound programs with intensive early phases and lighter maintenance phases should model both, because the same $126.18 can be generous on a coordination-only day and tight on a day with family meetings, school contacts and crisis follow-up.
New Hampshire pays most behavioral health services through New Hampshire Medicaid fee-for-service, administered by DHHS through the NH MMIS. That program holds the large majority of the state's published rates. A fee schedule sets a fixed price per unit of service; the provider bills units, and the state pays the scheduled amount.
Units, modifiers and provider levels
Units vary by code. H2019 is billed in 15-minute increments, 90840 in 30-minute increments, H2022 by the day and H0046 per service. Converting to an hourly figure, as the table does, is the only way to compare lines fairly. Modifiers identify who delivered the service, in what setting or under which funding arrangement, and they can change the price. Our comparison groups also tag the provider level: counseling and wraparound are compared at the licensed clinician level, while therapeutic behavioral services sit in a group led by physicians or licensed psychologists.
New Hampshire's May 2025 wage data:
- Mental health counselor: $26.36, against $28.53 nationally
- Mental health social worker: $30.72, against $28.98
- Clinical psychologist: $30.90, against $48.36
- Psychiatrist: $118.34, against $135.51
- Nurse practitioner: $66.13, against $63.61
- Psychiatric technician: $21.47, against $21.70
Social workers and nurse practitioners earn above the national median in New Hampshire, while counselors and clinical psychologists earn below it. For a practice choosing which licensed clinicians to hire for counseling volume, the wage gap favors counselors.
The psychiatrist and psychologist medians matter for prescribers and testing practices. Both run below national levels in New Hampshire, which partly offsets a rate schedule that is middle-of-the-pack. Psychiatric technicians, who deliver much of the H2019 work, earn close to the national median, so the shortfall on that line is a rate problem, not a labor-market advantage.
New Hampshire's published coverage data lists no prior authorization rules and no frequency limits on the core psychotherapy and diagnostic codes, from 90785 and 90791 through 90837, 90840, the family therapy codes and 90853. That is an administrative advantage. Practices can schedule intake, weekly therapy and crisis add-ons without waiting on approvals from the fee-for-service program.
Two caveats apply. First, the absence of a published rule in the fee-for-service schedule does not bind managed-care plans, which can run their own utilization management. Second, documentation standards still apply; medical necessity has to be supported in the record even when no advance approval is required.
New Hampshire's Medicaid managed care program is New Hampshire Medicaid Care Management (MCM), paid by capitation. The plans named in the state data are AmeriHealth Caritas New Hampshire, NH Healthy Families and WellSense Health Plan, and our behavioral health data counts 5 plans.
For behavioral health, plans negotiate; the published rate applies out of network. A provider's contracted rate with each MCM plan can differ from the fee schedule above. The published rates remain the benchmark for out-of-network claims and the starting point for contract negotiations. The New Hampshire managed care page shows the rule for each line.
What negotiation means for a behavioral health practice
Because plans are not required to pay at least the published rate on this line, each MCM contract is its own price. A practice should compare every plan's rate for H0046, the psychotherapy codes and H2019 against the state schedule, and treat any contract that pays below fee-for-service as a negotiating point. New Hampshire also runs home and community-based care for high-risk children with severe emotional disturbance and a 1915(i) Supportive Housing benefit, both paid fee-for-service and listed among its Medicaid programs.
New Hampshire's recent behavioral health notices concentrate on substance use treatment:
- Continuous Recovery Monitoring. A Medicaid public notice published 2026-07-02 proposes the service effective 2026-07-03.
- Medication Assisted Treatment. A state plan public notice published 2025-11-18 proposes mandatory state plan coverage effective 2025-10-01.
- Medically Monitored Residential Withdrawal Management. SPA NH-23-0017 proposed a rate increase effective 2023-01-01.
For providers in addiction treatment, these notices matter more than the mental health rate table. A new covered service such as Continuous Recovery Monitoring creates a billing opportunity only once a rate and code are published, so recovery programs should watch for the final fee schedule entry. Mandatory state plan coverage of Medication Assisted Treatment makes that benefit a permanent part of the state plan rather than an optional one, which supports longer-term investment in MAT capacity.
Within New England, New Hampshire sits between its neighbors on the lines we rank. Maine leads the country on therapeutic behavioral services, so a New Hampshire agency operating near the border faces a very different rate on the same service across the state line. On counseling, New Hampshire is ahead of both Massachusetts and Connecticut, two of the lower-paying ranked states.
For multi-state operators, the Vermont and Maine hubs show how neighboring schedules are structured, and the Maine behavioral health page shows the highest H2019 rate in the country. The national picture, including medians for every service group, is on the behavioral health Medicaid rates by state page.
The published schedule is most useful in three ways:
- Budgeting. Build service-line budgets from the hourly figures, not the unit rates, and apply your own wage and overhead costs. The gap between the 90840 margin and the H2019 margin shows why a blended budget can hide a losing line.
- Contract negotiation. Bring the fee-for-service rate, its effective date and its source document to every MCM negotiation. A rate unchanged since 2023 is a reasonable basis for asking plans to index contracted rates.
- Benchmarking. Compare your remittances line by line against the schedule and against other states. A remittance below the published rate on an out-of-network claim is worth questioning.
Rate history matters as well. New Hampshire's records go back to 1992, so practices can see how long each rate has held and whether a pending change is likely to reach their line. Plans with full access to the dataset are described on the pricing page.
Rates are compiled from official New Hampshire Medicaid publications, including the 2026 Fee Schedule - Covered Procedures Report with SA Requirements and the 2025 edition of the same report. Each rate links to its source document. Comparison groups match services that states pay under different codes, units are converted to an hourly figure where the unit allows it, and ranks include only states with a comparable rate. Wage figures are May 2025 medians. Full details are on the methodology page.