Home health Medicaid rates in Missouri are led by the highest speech therapy rate in the country. MO HealthNet pays $137.61 per 15 minutes for home health speech therapy on code G0153, or $550.44 an hour. That ranks 1st of 16 ranked states and is 366.4% above the national median of $29.50.
The same $137.61 figure appears across every Missouri home health code. Nursing, aide, physical therapy and occupational therapy are each listed at $137.61 per 15-minute unit, all effective 2024-07-01. That single rate across disciplines is the defining feature of Missouri's schedule.
| Service | Code | Missouri rate | Unit | National position |
|---|---|---|---|---|
| Speech therapy | G0153 | $137.61 | 15 min | 1 of 16, +366.4% |
| Nurse visit | G0299 (EP) | $137.61 | each 15 min | not ranked |
| Aide | G0156 | $137.61 | each 15 min | not ranked |
| Physical therapy | G0151 (96) | $137.61 | each 15 min | not ranked |
| Occupational therapy | G0152 (96) | $137.61 | each 15 min | not ranked |
Only speech therapy is ranked. The other four codes are listed with modifiers or unit wording that keeps them out of the national comparisons, but they carry the same rate and effective date.
MO HealthNet, Missouri's Medicaid program, publishes its fee schedules by provider type and announces changes in numbered bulletins. Home health agencies bill the national G-codes, each listed with the same amount.
A single rate across disciplines
Most states price nursing, aide and therapy differently, reflecting the different wages of the staff who deliver them. Missouri lists the same $137.61 for all five codes. For an agency, that means the value of a unit does not depend on which discipline delivers it. What changes between disciplines is the cost of delivering it.
Modifiers and units
The nursing code carries modifier EP and the PT and OT codes modifier 96, and the unit wording differs slightly between codes. Each rate links to its source document, which sets out the unit and modifier for each code. Billing staff should follow the source exactly, because the modifier is part of how a Missouri claim is priced.
Missouri's $137.61 per 15 minutes for speech therapy is well ahead of the next state, Michigan, at $85.93. New Mexico ($49.66), Rhode Island ($44.27) and Delaware ($43.42) complete the top five. At the bottom are Indiana ($18.78), New Hampshire ($18.40) and Ohio ($4.77).
Missouri's speech-language pathologist median wage was $42.92 an hour in May 2025, below the US median of $47.05. Against a $550.44 hourly rate, that wage is 11.1% of the rate once loaded, leaving $489.44 an hour. For an agency, speech therapy is the clearest growth line Missouri offers.
The constraint is supply, not rate
At this margin, the limit on a Missouri speech program is the number of speech-language pathologists an agency can hire and the units it is authorized to bill. Recruitment, credentialing and authorization management are the work that turns this rate into revenue.
Missouri's other home health codes share the speech therapy figure:
- Nurse visit (G0299, modifier EP): $137.61 each 15 minutes.
- Aide (G0156): $137.61 each 15 minutes.
- Physical therapy (G0151, modifier 96): $137.61 each 15 minutes.
- Occupational therapy (G0152, modifier 96): $137.61 each 15 minutes.
The national rankings these codes would sit in are led by the District of Columbia for nursing ($155.16 per 15 minutes), Minnesota for aide visits ($80.62 per visit) and Michigan for physical and occupational therapy ($343.72 and $278.92 an hour). The national medians are $23.96 per 15 minutes for nursing, $52.32 per aide visit, $120.52 an hour for PT and $117.42 an hour for OT.
Missouri wages are below national medians for every home health role:
| Role | Missouri median hourly wage | US median hourly wage |
|---|---|---|
| Registered nurse | $39.32 | $46.90 |
| Licensed practical nurse | $29.58 | $30.96 |
| Home health / personal care aide | $15.90 | $17.21 |
| Physical therapist | $47.75 | $49.40 |
| Occupational therapist | $46.77 | $48.24 |
| Speech-language pathologist | $42.92 | $47.05 |
With one rate across disciplines and wages that differ by role, the lowest-wage roles carry the widest margins. Aides, at $15.90 an hour, and LPNs, at $29.58, are the least costly staff to deploy against the shared rate.
When every discipline pays the same per unit, the agency's margin on a unit depends almost entirely on who delivers it. A unit of aide care and a unit of physical therapy earn the same $137.61, but the aide earns a third of what the physical therapist earns. That reverses the usual logic of home health, where aide services are the thinnest line.
What that means for an agency
In Missouri, aide services are among the most valuable units an agency bills, provided the services are authorized and medically necessary. Licensed practical nurses offer a similar advantage over registered nurses for routine nursing units. Physical and occupational therapists cost the most per unit, but even they leave a wide margin against $137.61.
Where the limits sit
The single rate does not mean any service can be substituted for another. Each code has its own authorization and its own daily unit limit, and each must match the plan of care and the licence of the person who delivers it. The opportunity is in delivering authorized care efficiently, not in shifting work between disciplines.
Missouri attaches both authorization rules and unit limits to each code:
- G0299 and G0300: 2 prior authorization rules each.
- G0151, G0152, G0153 and G0156: 1 each.
- Every code: a date-of-service limit, using MHD maximum units when CMS has no MUE.
The unit limit matters for speech therapy in particular, since the per-unit rate is high and the number of units per date of service is capped.
Managing limits in practice
With high-value units and a daily cap, the cost of a billing error is large. An agency should set its scheduling and billing systems to stop at the daily maximum for each code, document every unit against the plan of care, and keep authorizations current. Units delivered beyond the limit or outside an authorization are usually not paid, which turns an unusually valuable visit into a loss.
Three changes on file set the current rates:
- Rate Update for Home Health Services (MO HealthNet Bulletin Vol. 47-02), published 2024-07-02, effective 2024-07-01: +9.92%.
- Home Health Rate Increase Mass Adjustment (Bulletin Vol. 47-34A), published 2024-11-20, effective 2024-07-01.
- SPA MO-24-0016, approved by CMS on 2024-10-29, effective 2024-07-01, which increased certain rates for physician, dental, EPSDT and home health services among others.
All three carry the 2024-07-01 effective date shared by every Missouri home health rate, even though the mass adjustment bulletin was published in November 2024. A mass adjustment reprocesses claims already paid at the old rate, so agencies that billed in the second half of 2024 should have received the difference. No home health change since 2024 is on file, so the 9.92% update is the most recent increase an agency can point to.
Missouri has 4 plans on file under MO HealthNet Managed Care, including Healthy Blue, Home State Health Plan, UnitedHealthcare and the Show Me Healthy Kids specialty plan. Two rules apply:
- Physical, occupational and speech therapy: plans must pay at least the published rate, so the $137.61 therapy rate is a floor in managed care.
- Home health generally: plans negotiate; the published rate applies out of network.
Home and community-based services, personal care and private duty nursing are paid directly by the state, outside managed care. For an agency, the practical effect is that therapy is protected by a floor, while nursing and aide services for plan members depend on each contract. See the Missouri managed-care page.
MO HealthNet has moved neighboring lines more recently than home health. Bulletin Vol. 49-05 updated rates for DHSS-authorized home and community-based services effective July 1, 2026. Agencies that also deliver in-home services under DHSS authorization should review that bulletin, because it changes the revenue on households a home health agency often serves. For those lines, see the Missouri home care rates.
The home health schedule follows the state fiscal year, with the last change on July 1, 2024. July is the month to recheck it.
For budgeting, multiply authorized units by $137.61 and subtract wages by discipline; the lowest-wage roles leave the most. For service mix, speech therapy is the strongest line. For contracting, cite the therapy floor and use the published rate as the benchmark for nursing and aide services. Neighboring Kansas home health rates use very different units.
The Missouri Medicaid rates page covers all 68,416 current Missouri rates, and the pricing page explains full access with source documents and effective dates.
All rates are compiled from official state Medicaid publications, including MO HealthNet fee schedules and bulletins, and each rate links to its source document. See the methodology for how units are compared, and the home health Medicaid rates by state page for every state.