Physical therapy Medicaid reimbursement rates by state have a national median of $96.04 an hour across 50 states, based mainly on code 97110. Alaska pays the most at $176.68 an hour; Maine is lowest at $46.64. The pattern is similar for occupational and speech therapy: a few states lead on every discipline, and a few others trail on every discipline.
Outpatient and pediatric therapy practices bill time-based treatment codes and per-session evaluation codes, so this page covers both. We track 22,069 current therapy rates across all 51 jurisdictions, compiled from official state Medicaid publications with each rate linked to its source document.
PT, OT and speech therapy Medicaid rates in 2026
| Service | States | National median | Highest | Lowest |
|---|---|---|---|---|
| Physical therapy (per hour) | 50 | $96.04 | Alaska $176.68 | Maine $46.64 |
| Occupational therapy (per hour) | 49 | $110.60 | Alaska $338.72 | New Jersey $31.56 |
| Speech-language therapy | 51 | $61.64 | Washington $144.10 | New Hampshire $19.57 |
| PT evaluation | 49 | $81.72 | Alaska $149.65 | Illinois $10.27 |
| OT evaluation | 49 | $82.41 | Alaska $153.02 | Illinois $19.63 |
| Speech-language evaluation | 49 | $91.32 | Alaska $173.26 | Delaware $22.93 |
Therapy is one of the most completely covered industries on the site: every discipline has rates for at least 49 jurisdictions, and most of them can be ranked. That makes the state-by-state comparisons here unusually reliable.
97110 Medicaid rate by state: physical therapy
Alaska pays $176.68 an hour on code 97110, followed by New Mexico ($165.64), Montana ($147.04), Texas ($135.00) and North Dakota ($129.16). All five sit well above the $96.04 national median.
At the bottom, New Jersey pays $58.80 on 97110, California $48.88 on 97112 and Maine $46.64 on S8990. For a practice that bills mostly therapeutic exercise, the state it operates in can swing its Medicaid revenue per treatment hour from well under the median to far above it.
Occupational therapy rates by state (97530)
The national median for occupational therapy is $110.60 an hour, slightly above physical therapy. Alaska's top figure of $338.72 is on code 97533; Montana's $197.20 and North Dakota's $156.20 are on code 97530, the most common OT treatment code. New Mexico ($198.64) and Illinois ($156.36) complete the top five.
Pennsylvania ($52.00), Maine ($45.76) and New Jersey ($31.56) are lowest. New Jersey's figure is on 97535, which is not the main OT treatment code, so a New Jersey OT practice should compare its 97530 rate on the state page as well.
92507 Medicaid rate: speech-language therapy
Speech therapy has rates in all 51 jurisdictions, with a national median of $61.64 per published unit. Washington pays the most at $144.10 on code 92507, followed by Alaska ($118.16), Arizona ($109.12), Texas ($107.78) and North Dakota ($85.24).
The bottom three are tightly grouped: Pennsylvania at $21.70, Nebraska at $20.57 and New Hampshire at $19.57. Washington is a notable case: it is the only state that leads a therapy discipline without also leading the evaluation codes.
Therapy evaluation rates (97161, 97165, 92522)
Evaluations are paid per session, and the code a state pays depends on the complexity level billed. The national medians are $81.72 for a PT evaluation, $82.41 for an OT evaluation and $91.32 for a speech-language evaluation.
Alaska leads all three: $149.65 for PT on 97162 (see the 97161 rate by state for the low-complexity code), $153.02 for OT and $173.26 for speech. New Mexico is second on all three. Texas ($116.19), North Dakota and Virginia also rank in the top five for PT and OT evaluations.
At the low end, New Jersey appears on all three lists and Pennsylvania on two. Illinois lists $10.27 for a PT evaluation and $19.63 for an OT evaluation, and Delaware $22.93 for a speech evaluation on 92524. In those states, evaluation visits carry far less revenue than the national median suggests.
The spread between therapists and assistants
Therapy practices staff with licensed therapists and assistants, and the wage gap between them is large. Federal occupational wage data for May 2025 gives these national median hourly wages:
- Physical therapist: $49.40
- Occupational therapist: $48.24
- Speech-language pathologist: $47.05
- Occupational therapy assistant: $34.76
- Physical therapist assistant: $32.88
The gap between therapist and assistant wages is where a therapy practice's margin is made. At the national PT median of $96.04 an hour, a practice employing a physical therapist at the median $49.40 covers the wage with room for documentation time, scheduling and overhead. Where state rules allow assistants to deliver treatment, the $32.88 PTA median widens that margin considerably, and the same is true for OT assistants at $34.76.
What the wage data means for therapy practices
The national medians for PT ($96.04) and OT ($110.60) clear therapist wages comfortably on paper. The real constraint is billable time: evaluations, re-evaluations, documentation and cancellations all take therapist hours that are not billed at the treatment rate.
Speech therapy is the tightest discipline. Its national median of $61.64 is much closer to a speech-language pathologist's median wage of $47.05 than the PT or OT medians are to their wages. In Pennsylvania ($21.70), Nebraska ($20.57) and New Hampshire ($19.57), the published speech rate is below the median hourly SLP wage, so a pediatric speech practice in those states depends heavily on how many units the state allows per session; check the unit on each state page.
In the top-paying states, Alaska, New Mexico, Montana and North Dakota, therapy rates support competitive wages even with substantial unbilled time. Our methodology explains how time-based units are converted to hourly figures.
Updated 2026-10-05