Home Health Medicaid Rates in Oklahoma (2026)

Home health Medicaid rates in Oklahoma center on the skilled nursing visit. Oklahoma SoonerCare pays $21.45 per 15 minutes on G0299, which is $85.80 an hour, ranking 9th of 14 ranked states and sitting 10.5% below the national median of $23.96 per 15 minutes. It is a middle-of-the-pack rate in a discipline where most states are bunched near the bottom.

Oklahoma's nursing rate is the one home health discipline in this comparison with a published Oklahoma rate that can be ranked, so it is the rate this page is built around.

The national nurse visit ranking spans a wide range. The District of Columbia pays $155.16 per 15 minutes on code G0299, Texas $98.92 and Michigan $89.08 on G0493. After Delaware ($49.07) and Nevada ($28.46), the rates fall off quickly. At the bottom, Pennsylvania pays $16.55 on T1002, Maine $16.48 and California $15.21.

Oklahoma's $21.45 sits between those groups, closer to the bottom than the top. Being 10.5% below the median means a nurse-led Oklahoma agency earns somewhat less per unit than a typical state, but well above the lowest-paying states.

The rate has been in effect since October 1, 2024. Because it is paid per 15-minute unit, revenue scales with the time a nurse spends in the home: each additional quarter hour of skilled care adds a unit.

Time-based billing changes what an agency needs to manage compared with a per-visit state.

Every quarter hour counts

A nurse bills the number of 15-minute units that match the documented time providing skilled care. A 45-minute wound care visit bills three units, a full hour four. Missing start and stop times turn directly into missing revenue, so clean visit documentation is a billing control, not just a clinical one.

Long visits are paid, travel is not

Unlike a flat visit rate, Oklahoma's unit rate pays fairly for complex, longer visits. What it never pays for is the time between homes. That makes route planning the main cost lever: the same nurse, with the same patients, earns more per paid hour when visits are clustered.

Assessment before service

Oklahoma lists T1001 as the nursing assessment code. Assessments usually open a case or re-evaluate a patient's needs, and they set the plan of care that the G0299 units then deliver against.

Oklahoma's wage data favors agencies. Every home health role in Oklahoma has a median wage below the national figure except occupational therapy:

Those are May 2025 figures. For nursing, the median Oklahoma RN wage of $39.87 an hour is 66.0% of the $85.80 hourly rate. After a loaded wage that accounts for payroll costs, the margin is $29.13 per billed hour.

That margin has to pay for drive time between patients, charting, clinical supervision and agency overhead, none of which is billed. A margin of $29.13 is workable when routes are dense and visits are full length. It narrows quickly in rural areas where a nurse may spend as much time driving as in the home.

Where a plan of care allows a licensed practical nurse to make the visit, the lower $28.04 median LPN wage widens the margin further. Agencies that can match visit type to the right license level protect more of the rate.

The comparison with neighboring states is also part of the answer. A rate 10.5% below the national median, paired with nurse wages well below the national median, leaves Oklahoma in a more balanced position than its rank alone suggests. Low rates in a high-wage state are a much harder problem than moderate rates in a lower-wage one.

Oklahoma lists no prior authorization rules on code T1001, the nursing assessment code, and no unit limit. Fewer approval steps lower the administrative cost of opening a case.

That does not mean every home health service is approval-free. Agencies should check the rules attached to each code they bill, which appear alongside each rate on the Oklahoma Medicaid rates page. Physician orders and a current plan of care remain the foundation of every paid claim, whether or not prior authorization applies.

Oklahoma runs SoonerSelect, its risk-based Medicaid managed care program, with Aetna Better Health of Oklahoma, Humana Healthy Horizons in Oklahoma and Oklahoma Complete Health as medical plans. Oklahoma counts 5 plans in total.

Home health stays with the state

For home health, Oklahoma's rule is that services are paid directly by the state, outside managed care. A home health agency bills the SoonerCare fee schedule rather than negotiating rates with each plan. That removes contract negotiation from the home health line and makes the published $21.45 unit the rate actually paid. Private duty nursing and personal care follow the same rule.

Waiver services carry a floor

For home and community-based services, the rule is different: plans must pay at least the published rate. The SoonerCare fee schedule is the floor for those services under SoonerSelect: plans may pay more but not less. Programs such as the ADvantage waiver for older adults and adults with physical disabilities sit in this line. The Oklahoma managed care page shows the rule for each service line.

Two recent actions share the same October 1, 2024 effective date as the current nursing rate:

1. CMS approval of Oklahoma SPA 24-0022 (Attachment 4.19-B). Approved on January 15, 2025, effective October 1, 2024. Attachment 4.19-B is the part of a state plan that sets payment for non-institutional services.
2. DDS Administrative Letter 24-02. Published on September 27, 2024, it put a 10% rate increase into effect for DDS providers from October 1, 2024.

The 10% increase applies to providers of developmental disabilities services rather than to home health agencies as such, but agencies that also serve DDS waiver members will see it in that line of their billing.

Oklahoma amended 56 O.S. 4002.12 through HB 3650, extending the SoonerSelect minimum-rate floor to July 1, 2028, with the amendment taking effect November 1, 2026. For agencies that bill waiver and other managed-care lines alongside home health, that extension keeps plan payment tied to the published schedule for at least another two years.

For home health itself, the more relevant watch item is the SoonerCare fee schedule. Since home health is paid directly by the state, any future change to G0299 will arrive through a state plan amendment and a fee schedule update rather than through plan contracts. Agencies should track OHCA public notices for any SPA touching Attachment 4.19-B.

The clearest comparison is with Oklahoma's region. Texas, also in the West South Central region, ranks 2nd nationally at $98.92 per 15 minutes on G0299. Oklahoma's $21.45 is far below that. Arkansas, another regional neighbor, is not in the nurse ranking but pays $66.63 per aide visit on T1021.

Nationally, the aide and therapy rankings are led by Minnesota ($80.62 per aide visit) and Michigan ($343.72 an hour for physical therapy). Oklahoma has no ranked aide or therapy rate in this comparison, so agencies weighing those lines should work from the published schedule directly, and compare it with Oklahoma therapy rates for clinic-based work.

1. Budget nursing in units. Expected visits multiplied by average units per visit, times $21.45, gives the core revenue line.
2. Measure drive time. It is the cost that decides whether the $29.13 margin holds.
3. Use LPNs where the plan of care allows. The lower median wage widens the margin on the same unit.
4. Bill home health to the state. Plans do not pay home health; claims go to SoonerCare.
5. Watch Attachment 4.19-B. Rate changes for home health come through that part of the state plan.

Home health is a small part of SoonerCare's published schedule. Physician and practitioner services, hospital outpatient services and durable medical equipment account for most of Oklahoma's current rates. Those neighboring lines still matter to a home health agency, for three reasons.

First, referrals. Physician and hospital rates influence how readily practices and hospitals accept SoonerCare patients, and those patients are the source of most home health referrals. Second, transitions. Patients often move between home health, private duty nursing, personal care and waiver services as their needs change, and each of those lines has its own Oklahoma payment rule. Third, equipment. Many home health plans of care depend on supplies and equipment billed under separate schedules, and gaps there can delay a start of care.

An agency that understands the whole schedule, not just its own codes, is better placed to plan referrals and staffing. See Oklahoma private duty nursing rates for the hourly nursing line that sits next to home health.

Every rate here is compiled from official Oklahoma Medicaid publications, including the SoonerCare Title XIX Fee Schedule, and links to its source document. Oklahoma publishes all 29,954 current Medicaid rates across 107 service categories. Rankings compare nursing per 15 minutes. Wages are May 2025 medians, and margins subtract a loaded wage from the hourly rate.

The national home health page compares all disciplines, and our methodology explains how units are converted and ranked.