Home health Medicaid rates in Nevada split sharply by discipline. Nevada Medicaid pays $28.46 per 15 minutes for a skilled nursing visit on G0299, or $113.84 an hour, which ranks 5th of 14 ranked states and sits 18.8% above the national median of $23.96. Therapy goes the other way: physical, occupational and speech therapy all pay $18.81 per 15 minutes, placing Nevada near the bottom of every therapy ranking.
For a Nevada agency, that split shapes the business. Nursing visits carry a healthy cushion over wages. Therapy visits, at Nevada's therapist wages, barely cover the clinician.
The nurse visit is Nevada's strongest home health rate. At $28.46 per 15 minutes on code G0299, Nevada is the fifth state in the national top five, behind the District of Columbia ($155.16), Texas ($98.92), Michigan ($89.08 on G0493) and Delaware ($49.07).
The national ranking is bunched at the bottom, with Pennsylvania at $16.55, Maine at $16.48 and California at $15.21. The median of $23.96 sits near those states. Nevada's $28.46 is therefore a genuinely above-median rate in a discipline where most states pay little more than the floor.
What this means in practice is that a Nevada nursing visit gets paid for the time it actually takes. A nurse who spends an hour on wound care bills four units; one who spends 30 minutes on a medication check bills two. That is fairer to complex cases than a flat visit rate, but it also means documentation of start and end times carries real money.
Nevada prices every home health discipline in 15-minute units rather than per visit. That one design choice explains most of how Nevada looks in national comparisons.
Time-based units
Each unit covers up to 15 minutes of direct service. An agency bills the number of units that matches the documented time in the home, on the code for the discipline that made the visit. Nursing, aide and therapy visits are separate claim lines, even when they happen on the same day for the same patient.
Why some Nevada rates are ranked and others are not
Nursing and speech therapy are compared nationally per 15 minutes, and physical and occupational therapy per hour, so Nevada's units convert cleanly to those scales. The aide visit is compared per visit in most states, which Nevada does not use. Nevada pays $7.41 per 15 minutes on G0156, or $29.64 an hour, and that cannot be placed on a per-visit scale without assuming how long a visit lasts.
Nevada pays one rate, $18.81 per 15 minutes, across all three therapy codes. Converted to an hourly basis that is $75.24.
| Discipline | Code | Per hour | Rank | vs national median |
|---|---|---|---|---|
| Physical therapy | G0151 | $75.24 | 17 of 19 | -37.6% |
| Occupational therapy | G0152 | $75.24 | 15 of 18 | -35.9% |
| Speech therapy | G0153 | $75.24 | 13 of 16 | -36.2% |
Nevada is one of the three lowest-listed states for physical therapy, alongside Indiana ($74.52) and Ohio ($19.08). The national medians are $120.52 an hour for physical therapy and $117.42 for occupational therapy, and $29.50 per 15 minutes for speech.
A single flat therapy rate also means Nevada does not distinguish between disciplines with different labor markets. Speech-language pathologists and physical therapists are paid from the same $18.81 unit, so whichever therapist costs the agency more is the one that loses more money per visit.
Nevada wages run above the national median for almost every home health role. Federal wage data for May 2025:
- Registered nurses earn $49.84 an hour in Nevada, against $46.90 nationally.
- Licensed practical nurses earn $36.62, against $30.96.
- Physical therapists earn $53.48, against $49.40.
- Occupational therapists earn $53.13, against $48.24.
- Speech-language pathologists earn $50.25, against $47.05.
- Home health aides earn $16.19, slightly below the US median of $17.21.
The combination matters more than either number alone. A state with high wages can still be workable if rates are high too; Nevada pairs above-median wages with below-median therapy rates, which is the hardest position for an agency to be in.
Therapy does not cover the therapist
After a loaded wage, the margin per billed hour is negative for both physical and occupational therapy: the rate does not cover the therapist. Speech therapy is barely positive. These figures cover only the clinician's paid time in the home.
Nursing carries the agency
Nursing is the opposite case. The median RN wage leaves a margin of $43.00 an hour after loaded wages, the widest cushion of any Nevada discipline. Aides sit in between.
What the margins leave out
These margins exclude drive time, documentation and overhead, all of which home health agencies carry on every visit. Under 15-minute billing, drive time is never paid directly, so a long drive to a short visit erodes even the nursing margin. On those terms, a Nevada agency's nursing line carries its therapy line.
Nevada's risk-based managed care program is the Mandatory Health Maintenance Program. Nine plans are counted in Nevada, including Anthem Blue Cross and Blue Shield Healthcare Solutions, CareSource Nevada, Health Plan of Nevada, Molina Healthcare of Nevada and SilverSummit Health Plan.
Home health: plans negotiate
For home health, Nevada's rule is that plans negotiate their own rates, and the published rate applies out of network. The schedule is a reference point rather than a guaranteed price. An agency in a plan's network is paid whatever its contract says, which may be above or below the published units.
Therapy: the published rate is a floor
For physical, occupational and speech therapy as a service line, Nevada's rule is different: plans must pay at least the published rate. That rule protects therapy rates from being negotiated below $18.81 per 15 minutes, though it does not raise them.
Lines paid outside managed care
Private duty nursing, personal care and home and community-based services are paid directly by the state, outside managed care. Agencies that also deliver these services work with Nevada Medicaid directly for them. The Nevada managed care page lists the rule for each service line.
All of Nevada's home health rates in this comparison have been in effect since January 1, 2024. No newer edition has moved them.
For an agency, a stable rate is predictable but not neutral. Wages for nurses and therapists have continued to move while the rates have not, so the margins above describe a position that gets slightly tighter each year the schedule stays put. Agencies planning for 2027 should budget on the current units, model wage growth on top, and watch Nevada's web announcements and public notices for any home health rate action. See Nevada private duty nursing rates for the hourly nursing line that sits next to home health.
Nevada's profile is unusual: top five for nursing, bottom three for physical therapy. The national leaders show what is possible on the therapy side. Michigan pays $343.72 an hour for physical therapy and Utah $330.48, then New Mexico at $198.64. Neighboring Utah is the clearest contrast for an agency working both sides of the border.
On nursing, Nevada beats every state outside the top four. Few states reward skilled nursing time as well, and almost none in the Mountain region.
- Lead with skilled nursing. It is the only Nevada discipline with a strong margin. Growth plans built on nursing referrals rest on the firmest ground.
- Treat therapy as part of the plan of care, not a profit line. Therapy visits complete an episode and keep referral sources satisfied, but they need to be staffed efficiently, with tight scheduling and short drive times.
- Document time precisely. Every 15 minutes is a unit. Missing start or end times cost revenue directly.
- Use the published units in plan negotiations. Since plans negotiate home health rates, compare every offer against the published units and ask for at least the schedule.
- Budget for wage drift. With rates flat since January 2024, any wage increase comes straight out of margin.
Home health is a small part of Nevada Medicaid. The state publishes all 79,042 current Nevada Medicaid rates across 109 service categories and 13 programs, with history back to 1980. Physician and practitioner services and hospital outpatient services dominate the published rates.
The wider schedule matters to home health agencies because it shapes referral flow: physician rates influence how many practices take Medicaid patients, and home and community-based waiver rates decide where long-term patients go when a home health episode ends. The full Nevada Medicaid rates page covers every service line.
Every rate here is compiled from official Nevada Medicaid publications, specifically the state's provider-type reimbursement schedules, and each rate links to its source document. Rankings compare states on a common unit: per 15 minutes for nursing and speech therapy, per hour for physical and occupational therapy, and per visit for aides. States paying in a different unit are shown but not ranked. Wages are May 2025 median hourly figures, and margins subtract a loaded wage from the hourly rate.
See the national home health page for cross-state comparisons and our methodology for how 15-minute units are converted to hourly rates.