Home health Medicaid rates in Delaware are among the highest in the country on every ranked discipline. Delaware Medicaid pays $49.07 per 15 minutes for a home health nurse visit on code G0299, or $196.28 an hour. That ranks 4th of 14 ranked states and is 104.8% above the national median of $23.96.
Delaware and Michigan are the only two states that place in the national top five for nursing, physical therapy, occupational therapy and speech therapy at once. Delaware also writes a payment floor for managed-care plans into state law, which makes the published rate unusually meaningful for agencies that contract with plans.
All five Delaware home health rates took effect on 2026-01-01:
| Service | Code | Delaware rate | Per hour | Rank | vs national median |
|---|---|---|---|---|---|
| Nurse visit | G0299 | $49.07 / 15 min | $196.28 | 4 of 14 | +104.8% |
| Physical therapy | G0151 | $49.25 / 15 min | $197.00 | 4 of 19 | +63.5% |
| Occupational therapy | G0152 | $44.61 / 15 min | $178.44 | 3 of 18 | +52.0% |
| Speech therapy | G0153 | $43.42 / 15 min | $173.68 | 5 of 16 | +47.2% |
| Aide visit | G0156 | $10.48 / 15 min | $41.92 | not ranked | n/a |
The aide rate is priced in 15-minute units on G0156 rather than per visit on T1021, so it is not part of the aide ranking. Everything else ranks in the national top five.
Delaware pays every home health discipline in 15-minute units, including the aide. That is less common than it sounds. Many states pay aides a flat amount per visit and pay nurses per visit or per episode, which means a long visit earns no more than a short one.
What 15-minute billing means in practice
Under unit billing, revenue follows documented time. A 45-minute nurse visit bills three units, and a 30-minute aide visit bills two. Agencies are rewarded for accurate time capture and penalized for undocumented minutes. The trade-off is that short, efficient visits earn less than they would under a flat visit rate, so the incentive is to deliver the time the care plan calls for rather than to compress it.
Nurse codes G0299 and G0300
G0299 covers registered nurse visits and G0300 covers licensed practical nurse visits. The ranking uses the G0299 figure. Agencies that staff routine visits with LPNs should check the G0300 rate in the full Delaware schedule before assuming RN-level revenue for every nursing hour.
Only three places pay more for a nurse visit: the District of Columbia at $155.16 per 15 minutes, Texas at $98.92 and Michigan at $89.08 on G0493. Delaware's $49.07 is more than double the median, and well ahead of fifth-placed Nevada at $28.46.
The low end is far away. Pennsylvania pays $16.55 on T1002, Maine $16.48 and California $15.21. A Delaware nursing hour pays $196.28 against a Delaware RN median wage of $47.85, so the wage is 34.6% of the rate and the agency keeps $128.27 an hour after a loaded wage.
That margin has to cover more than the nurse's time. Drive time between homes, documentation after the visit, supervision, supplies and the agency's own overhead all come out of it. Even so, Delaware is one of the few states where a skilled nursing hour comfortably funds those costs.
Therapy is where Delaware's position is most consistent:
- Physical therapy (G0151): $197.00 an hour, 4th of 19. Only Michigan ($343.72), Utah ($330.48) and New Mexico ($198.64) pay more.
- Occupational therapy (G0152): $178.44 an hour, 3rd of 18, behind Michigan ($278.92) and New Mexico ($198.64).
- Speech therapy (G0153): $173.68 an hour, 5th of 16.
Delaware sits alongside New Mexico and Rhode Island as the group just below Michigan in therapy. The gap to the bottom is wide: Indiana pays $74.52 an hour for PT and $68.84 for OT. For a therapist deciding where to work, the Delaware rate is more than double what Indiana pays for the same hour.
The three therapy rates are also close to one another, so the discipline mix of an agency's caseload does not swing revenue much. A shift from physical to occupational therapy visits lowers the hourly rate only modestly.
Delaware wages for home health roles are close to US medians, which means the high rates translate into wide margins:
- Physical therapy: PT median wage $49.06 (US $49.40), 35.4% of the rate, leaving $127.27 an hour.
- Occupational therapy: OT wage $49.10 (US $48.24), 39.1% of the rate, leaving $108.65.
- Speech therapy: SLP wage $49.40 (US $47.05), 40.4% of the rate, leaving $103.47.
- Aide visit: aide wage $16.50 (US $17.21), 55.9% of the $41.92 hourly rate, leaving $18.47.
Licensed practical nurses earn a Delaware median of $33.03 (US $30.96). For an agency, Delaware is one of the few states where every home health discipline carries a positive margin after loaded wages, and where nursing and therapy margins are of similar size.
Where the margin is thinnest
The aide line is the tightest. At 55.9% of the rate, the aide wage leaves less room for travel and supervision than any clinical discipline. Delaware's aide wage is below the US median, which helps, but recruitment pressure that pushes wages up would squeeze this line first.
Delaware's managed-care programs are the Diamond State Health Plan and the Diamond State Health Plan Plus managed LTSS program, with 5 plans on file, including AmeriHealth Caritas Delaware, Delaware First Health and Highmark Health Options.
Two rules on file shape what those plans pay for home health:
- 29 Del. C. s.7931(f) (SB 109), enacted 2021-09-30: MCOs must pay home health and home care for LTSS providers at or above the DMMA rate.
- The 2023 MCO Master Service Agreement, effective 2023-01-01, which added Delaware First Health and set a home health floor.
For home health generally, the state's managed-care rule is that plans negotiate and the published rate applies out of network. The statutory floor sits on top of that for LTSS providers, so the DMMA rate is the minimum a plan can offer them. For physical, occupational and speech therapy, plans also negotiate. See the Delaware managed-care page for plan detail.
What the floor means in a negotiation
A floor changes the starting point. An LTSS home health provider negotiating with a Delaware plan does not have to argue up from a discount; the published rate is the minimum. Agencies outside the LTSS category, or negotiating therapy rates, should use the published rate as their reference and ask plans to match it.
No prior authorization rules are recorded for any Delaware home health code in this comparison: G0151, G0152, G0153, G0156, G0299 and G0300 all show zero. No unit limits are recorded either. Combined with the rate levels above, that makes Delaware a comparatively low-friction state to bill under fee-for-service.
Managed-care plans can set their own authorization requirements, so agencies serving Diamond State Health Plan members should confirm each plan's process separately. The absence of state-level rules does not mean every plan waives review.
Delaware's home health rates move with the annual DMAP schedules, and the most recent editions show how the state handles them. The physician, dental and ASC schedules all carry new 2026 editions, and the home health codes in this comparison were reset on the same 2026-01-01 date. Agencies should expect the next reset to arrive on a calendar-year cycle and should read each new edition rather than assume rates carry forward.
The other item to track is managed care. CMS approved a renewal of Delaware's state directed payment for home and community-based services for calendar year 2026, alongside renewals for hospital, behavioral health and nursing facility payments. Directed payments are how a state requires its plans to pay a set amount or a set increase for a class of providers. For home health agencies that also deliver HCBS, the renewal is a signal that plan payments for that work are tied to state policy rather than left entirely to negotiation.
Finally, watch the floor statute itself. Because 29 Del. C. s.7931(f) links the plan minimum to the DMMA rate, every increase to the published home health rate automatically raises what plans must pay LTSS providers.
Delaware's home health rates stand out in the Mid-Atlantic. Neighbors such as Maryland and Pennsylvania sit well below it on nursing; Pennsylvania's T1002 figure of $16.55 is near the bottom nationally. An agency operating across state lines will find that a Delaware nursing hour is worth several times a Pennsylvania one.
Agencies that also deliver personal care or extended nursing shifts should compare the Delaware home care rates and the Delaware private duty nursing rates.
For budgeting, Delaware's single 2026-01-01 effective date is an advantage: every rate in this comparison was set at the same time, so a budget built on them is internally consistent.
For staffing, the margin figures show where hiring pays. Nursing and physical therapy carry the widest margins, so expanding clinical capacity is more sustainable than growing aide volume.
For plan contracting, cite the statutory floor where it applies and the published rate where it does not. The Delaware Medicaid rates page lists all 46,693 current Delaware rates, and the pricing page explains full access with source links and effective dates.
All rates are compiled from official state Medicaid publications, including the DMAP fee schedules issued by the Division of Medicaid and Medical Assistance, and each rate links to its source document. Rankings compare states only where units can be placed on a common basis, which is why the G0156 aide rate is shown but not ranked. Wages are May 2025 medians. See the methodology for how rates are ranked, and the national home health page for every state.