Therapy Medicaid rates in California are among the lowest in the country for treatment time. Medi-Cal pays $48.88 an hour for physical therapy under code 97112, which ranks 48th of 49 states and is 49.1% below the national median of $96.04. The rate is $12.22 per 15-minute unit, effective 2026-10-01.
What makes California unusual is the collision between that rate and the state's wages. California therapists earn well above the national median, and at the Medi-Cal treatment rate, the median physical therapist wage exceeds what the program pays for an hour of therapy. The evaluation codes tell a different story, with PT and OT re-evaluations ranking in the upper half. All rates here are compiled from official California Department of Health Care Services publications, and the California Medicaid rates hub links each to its source document.
Every therapy rate in our California data carries the same effective date, 2026-10-01.
| Service | Code | Medi-Cal rate | Rank | vs national median |
|---|---|---|---|---|
| Physical therapy | 97112 | $48.88/hour | 48 of 49 | -49.1% |
| Occupational therapy | 97530 | $56.52/hour | 45 of 48 | -48.9% |
| Speech-language therapy | 92507 | $37.69 | 30 of 39 | -38.9% |
| PT re-evaluation | 97164 | $94.14 | 12 of 46 | +15.2% |
| OT re-evaluation | 97168 | $87.32 | 17 of 46 | +6.0% |
| Speech-language evaluation | 92521 | $62.81 | 40 of 44 | -31.2% |
California appears on the national low list for physical therapy, alongside New Jersey ($58.80) and Maine ($46.64). Only Maine ranks lower.
Medi-Cal therapy payment has three features that a billing team needs to understand before modeling revenue.
Units and sessions
PT and OT treatment codes such as 97112 and 97530 are priced per 15-minute unit. Visit revenue is the unit rate multiplied by documented billable units. Speech therapy under 92507 is priced per session, and evaluations and re-evaluations per service.
Modifiers
DHCS publishes a separate Medi-Cal UA and UB Modifier Maximum Allowable Reimbursement list, current as of October 2026. Modifiers can change the maximum allowable amount for a therapy line, so claims should be built with the modifier the schedule expects for the service and setting.
Medi-Cal against Medicare
Medi-Cal's 97110 rate is 30% to 36% of the Medicare non-facility rate for the same code, depending on the Medicare locality. For a mixed-payer practice, that means a Medi-Cal visit earns roughly a third of a comparable Medicare visit, which is why payer mix dominates California therapy economics.
California wages run well above the national medians for every therapy role. In May 2025:
- Physical therapists earned a median $59.71 an hour, against $49.40 nationally.
- Occupational therapists earned $59.86, against $48.24.
- Speech-language pathologists earned $57.20, against $47.05.
- Physical therapist assistants earned $39.96, against $32.88.
- Occupational therapy assistants earned $39.31, against $34.76.
Set those wages against the Medi-Cal treatment rates and the result is negative:
- Physical therapy (97112): the median wage equals 173.6% of the $48.88 hourly rate, leaving a shortfall of $35.99 an hour after a loaded wage.
- Occupational therapy (97530): the median wage equals 150.5% of the $56.52 hourly rate, a shortfall of $28.56 an hour.
In plain terms, an hour of Medi-Cal treatment delivered by a licensed therapist at the median California wage does not cover that therapist's pay, let alone overhead.
Practices that serve Medi-Cal patients in California typically rely on a combination of strategies rather than any single fix:
- Payer mix. Medi-Cal volume is balanced against commercial and Medicare caseloads that pay more per unit. Tracking the Medi-Cal share of visits, and its trend, is a core management measure.
- Assistant-delivered care. Physical therapist assistants and occupational therapy assistants earn less than therapists. Where Medi-Cal rules permit supervised assistants to deliver treatment, they lower the cost of each unit, though assistant wages are also above national levels.
- Evaluation and re-evaluation focus. Re-evaluations are the best-paid part of the schedule relative to other states. Timely, clinically justified re-evaluations make a bigger contribution here than elsewhere.
- Setting choice. School-based, hospital outpatient and clinic settings can be paid under different arrangements. Practices should know which schedule applies to each setting they serve.
Medi-Cal publishes therapy rates for more than one setting. Alongside the fee-for-service schedule, the Medi-Cal school-based services program for Local Educational Agencies carries its own therapy rates, including speech-language evaluation codes. The same code can therefore have more than one published amount depending on who bills it and where the service is delivered.
For therapy providers, that has three practical consequences:
- Know which schedule applies. A contractor delivering services in schools may be paid under a different arrangement from the same therapist billing Medi-Cal fee-for-service from a clinic.
- Benchmark like with like. Comparing a clinic's Medi-Cal revenue with school-based rates, or the reverse, gives a misleading picture.
- Watch the evaluation codes. Speech-language evaluations are where setting-specific schedules matter most, because evaluations are a large share of school-based caseloads.
Groups that operate across clinic and school settings should keep separate revenue models for each.
The re-evaluation codes are where Medi-Cal comes closest to other states. Code 97164 pays $94.14, ranking 12th of 46 and 15.2% above the $81.72 national median. Code 97168 pays $87.32, 17th of 46 and 6% above the $82.41 median.
Speech is the exception. The speech-language evaluation under 92521 pays $62.81, 40th of 44 and 31.2% below the $91.32 median. Combined with a 92507 treatment rate 38.9% below the median, speech practices face below-median rates at both ends of the episode. For a pediatric speech practice, that makes California one of the hardest Medi-Cal markets to serve at scale.
Medi-Cal attaches more authorization rules to therapy codes than most states:
- 97530: four prior-authorization rules.
- 92507, 97110 and 97112: three rules each, as do the evaluation codes 97163 and 97167 and the re-evaluations 97164 and 97168.
- 92522 and 92523: two rules each.
- 92521 and 92524: one rule each.
None of the listed codes carries a unit limit. With authorization rules on the core treatment codes for both PT and speech, intake teams should confirm approval before treatment begins, since an unauthorized claim at these rates leaves no margin to absorb rework.
An authorization routine that holds up
A dependable routine is to submit the authorization request with the evaluation findings, record the approved services and dates, and set reminders well before the authorization runs out so a renewal can be filed without a gap in care. A visit delivered after an authorization lapses is rarely recoverable.
California enrolls many Medi-Cal members in managed care through County Organized Health System and Two-Plan models, and our data counts 231 plans and programs. For physical, occupational and speech therapy, though, the rule on file is: paid directly by the state, outside managed care. That means the published Medi-Cal fee schedule is the rate that applies to therapy claims, not a negotiated plan rate.
That differs from physician and practitioner services in California, where plans negotiate and the published rate applies out of network. The California managed-care page lists the plans and directed payments on file.
For therapy practices, direct state payment removes plan negotiation from the picture. The only lever on rate is the state schedule itself; the levers on margin are cost, mix and authorization discipline.
The gap between Medi-Cal and the top of the table is wide. Alaska pays $176.68 an hour on 97110, New Mexico $165.64 and Montana $147.04. On occupational therapy, Alaska's $338.72 compares with California's $56.52. On speech, Washington, California's northern neighbor on the Pacific coast, pays $144.10 for 92507. Oregon, Nevada and Arizona are the other western comparisons.
For therapy groups operating in the West, California is a high-wage, low-rate state where Medi-Cal treatment volume needs careful modeling.
Model Medi-Cal therapy by setting and discipline, with authorization lead time built into the patient flow. Budget re-evaluations separately, since they are the best-paid part of the schedule, and keep Medi-Cal volume as a deliberate share of the caseload rather than an accident of referrals.
California's therapy line is one of its largest, with 11,727 current rates, part of all 227,056 current California Medicaid rates available through MedicaidRate plans.
Rates on this page are compiled from official California Department of Health Care Services publications, and each rate links to its source document, including the Medi-Cal Rates files and the Medi-Cal UA and UB Modifier Maximum Allowable Reimbursement list. The national therapy rates hub compares every state on the same basis, and our methodology explains how rates are converted and ranked.