Behavioral health Medicaid rates in Wyoming are near the top of the country for community and counseling services. Wyoming Medicaid pays $149.80 an hour for therapeutic behavioral services on code H2019, which ranks 2nd of 28 states and sits 70.6% above the $87.82 national median. Its counseling rate also ranks 2nd.
Most Wyoming behavioral health rates took effect on 2026-07-01, so the schedule is current. Residential treatment is the exception: Wyoming ranks 14th of 15 on that service. For a provider deciding where to put staff and beds in Wyoming, the schedule sends a clear signal toward community-based work.
| Service | Code | Wyoming rate | Rank | vs national median |
|---|---|---|---|---|
| Therapeutic behavioral services | H2019 (HL) | $149.80 an hour | 2 of 28 | 70.6% |
| Mental health counseling | H0046 (HL) | $42.34 | 2 of 12 | 61.7% |
| Skills training and development | H2014 (HL) | $56.56 an hour | 14 of 33 | 10.5% |
| Mental health assessment (non-physician) | H0031 | $116.17 | 16 of 27 | -7.1% |
| Psychiatric residential treatment | 0919 | $443.78 a day | 14 of 15 | -15.5% |
Three of the five ranked services sit above the national median, two of them far above it. The two below-median services, assessment and residential treatment, are also the two that did not change on 2026-07-01. That timing matters: the July update lifted the community codes, while the intake and residential rates carry older effective dates. The full dataset holds all 47,114 current Wyoming Medicaid rates, each linked to its source on the Wyoming Medicaid rates hub.
H2019 pays $37.45 per 15 minutes with modifier HL, effective 2026-07-01. Only Maine, at $449.72 an hour, pays more. Wyoming sits ahead of Washington ($145.40), Idaho ($142.44 on H0036) and Ohio ($128.96). The lowest states are Wisconsin ($21.44), Arizona ($19.52) and Alabama ($16.80).
A rate of this size changes what a therapeutic behavioral services program can look like. In low-paying states, the service is often staffed with the least-credentialed workers to make the numbers work. At $149.80 an hour, a Wyoming provider can staff the service with experienced clinicians, pay for supervision and travel time, and still keep a margin. In a state with long drive times between members, the travel cushion alone is significant.
Counseling on H0046 with modifier HL pays $42.34, effective 2026-07-01. It ranks 2nd of 12, just behind South Dakota at $42.50, and ahead of the District of Columbia ($35.74) and Washington ($34.22). It is 61.7% above the $26.19 national median.
Counseling is a high-volume, lower-intensity service, so even modest per-unit differences add up across a caseload. A rate this far above the median gives Wyoming agencies room to keep counselors on salary rather than on per-visit pay, which tends to help retention in rural markets where replacing a clinician can take months.
Skills training (H2014)
Skills training on H2014 with modifier HL pays $14.14 per 15 minutes, or $56.56 an hour. It ranks 14th of 33 and is 10.5% above the $51.20 national median. It is not a standout like H2019, but it is comfortably above the middle of the national range and was refreshed on 2026-07-01.
Assessment (H0031)
Assessment on H0031 pays $116.17, effective 2024-07-01, older than the July 2026 changes. It ranks 16th of 27, 7.1% below the $125.00 national median. Intake is close to the national middle, so it neither drags on a program nor subsidizes it. Agencies with high admission volume should still model intake as a cost center that later services repay.
Wyoming's outpatient psychotherapy comparison rate is $109.65 an hour on 90838, effective 2026-07-01. It is not ranked because it is published as an hourly rate rather than per session.
At a $30.28 median counselor wage, wages take 39.3% of that rate, leaving $66.61 an hour after loaded wages. That is a healthy margin for a licensed therapy practice, enough to cover scheduling, documentation, supervision and the gaps in a clinician's day.
Wyoming behavioral health wages
Wyoming's May 2025 median wages for the roles with data:
- Mental health counselor: $30.28, against $28.53 nationally
- Mental health social worker: $28.51, against $28.98
- Clinical psychologist: $43.22, against $48.36
- Nurse practitioner: $63.56, against $63.61
Counselor wages run above the national median, but Wyoming's counseling and therapy rates more than make up for it. Psychologist wages run below the national median, which makes psychological services comparatively affordable to staff.
Wyoming lists no prior authorization rules on the outpatient psychotherapy codes, from 90785 and 90791 through 90837, 90838, the crisis codes 90839 and 90840, and the family codes 90846 and 90847. Outpatient therapy can be scheduled and billed without waiting on an approval.
Residential treatment is different. Code 0919 carries 2 prior authorization rules, so residential admissions need authorization before the stay begins. For a residential program, that means building authorization into the admission workflow and tracking approval dates closely, since a stay that starts before approval is a billing risk.
Wyoming's psychiatric residential treatment rate is $443.78 a day on code 0919, effective 2026-01-01. It ranks 14th of 15 and is 15.5% below the $525.10 national median; only Nebraska, at $283.19, pays less. Minnesota leads at $1,244.07 a day.
A residential daily rate has to carry 24-hour staffing, the building, food, education coordination and clinical services. When that rate sits near the bottom of the national range, every unfilled bed and every day of delayed authorization weighs more heavily. Residential operators in Wyoming have less room for error than their community-based peers.
Wyoming rewards outpatient and community work and pays comparatively little for residential care.
- Community agencies. Counseling, therapeutic behavioral services and skills training are all at or above the national median, refreshed on 2026-07-01. This is where Wyoming's schedule carries margin.
- Licensed therapy practices. A $109.65 hourly psychotherapy rate with no authorization step supports a straightforward outpatient model.
- Residential programs. A daily rate that ranks 14th of 15 and an authorization step before admission make this the hardest line to sustain.
Providers deciding where to add capacity have a clear signal from the schedule: build community and outpatient services first, and expand residential capacity only with a firm view of occupancy.
Wyoming pays behavioral health through Wyoming Medicaid fee-for-service, run by the Department of Health. Youth high-fidelity wraparound runs through the Wyoming Care Management Entity, with Magellan Healthcare, Inc. named as the Care Management Entity. Our behavioral health data counts 18 plans and coverage groups.
Because there are no managed care plans setting their own behavioral health rates, the published fee schedule is the price. That simplifies budgeting: there is no plan-by-plan contract to negotiate, and a rate change announced by the state flows straight to claims. It also means providers cannot negotiate their way out of a weak rate, which is why the residential rate matters so much. See the Wyoming managed care page for detail.
- Provider Rate Changes Effective July 1, 2026. A bulletin issued 2026-09-23 covers rate changes effective 2026-07-01, the date most rates on this page carry.
- Fee Schedule Effective Dates Update. A public and tribal notice published 2026-06-04, effective 2026-07-01.
- Wyoming SPA WY-26-0007-A. Approved by CMS on 2026-10-01, effective 2026-07-01.
- Children's Mental Health Waiver. A public and tribal notice published 2026-10-01 announces intent to amend the waiver, moving it from the CME to fee-for-service, effective 2027-07-01.
- Care Management Entity rates. Amendment Two to the CME contract set a provider fee schedule effective 2024-07-01, and the CME waiver renewals noticed in 2024 carried a 2.1% change.
What to watch
The waiver change is the one that matters most for youth providers. Moving from the CME to fee-for-service changes who pays the claim, which can change billing setup, enrollment steps and the timing of payment. Providers serving youth in wraparound should plan for that transition well before 2027-07-01. The bulletin issued in September 2026 for July rates is also a reminder that Wyoming can announce rate changes after their effective date, so check for retroactive adjustments on claims paid in the interim.
- Budgeting. Model revenue by code. A blended rate hides the difference between a $149.80 H2019 hour and a $443.78 residential day that has to cover round-the-clock staffing.
- Benchmarking. Compare with neighbors on the Montana and Colorado hubs, and with the national picture on behavioral health Medicaid rates by state.
- Rate advocacy. With no plans to negotiate with, the state's rate process is the only route to a better residential rate; a 14th-of-15 rank is a concrete figure to bring to public comment.
- Expansion planning. Favor services refreshed on 2026-07-01, which reflect the state's most recent pricing decisions.
Rates are compiled from official Wyoming Medicaid publications, including the Wyoming Medicaid Downloadable Fee Schedule and the Wyoming Medicaid APC-Based Fee Schedule for July 2026. Each rate links to its source document. Rankings compare the rate for the same service across states that publish one, using the per-hour figure where a service is billed in time units. Wages are May 2025 medians for the role that typically delivers the service. Rankings follow our methodology; access to the full dataset is described on our pricing page.