Therapy Medicaid rates in Iowa favor speech over physical and occupational therapy. Iowa Medicaid pays $90.60 an hour for physical therapy under code 97112, which ranks 31st of 49 states and is 5.7% below the national median of $96.04. The rate is $22.65 per 15-minute unit, in effect since 2020-05-01. Speech therapy under 92507 pays $76.38, which ranks 7th of 39 states.
Iowa's other defining feature is how firmly its fee schedule binds. For therapy, as for most service lines in Iowa, managed-care plans must pay at least the published rate. That makes the numbers on this page a floor for in-network payment, not just a fee-for-service reference. All rates are compiled from official Iowa Medicaid publications, and the Iowa Medicaid rates hub links each to its source document.
| Service | Code | Iowa rate | Effective | Rank | vs median |
|---|---|---|---|---|---|
| Physical therapy | 97112 | $90.60/hour | 2020-05-01 | 31 of 49 | -5.7% |
| Occupational therapy | 97533 | $85.68/hour | 2021-04-01 | 37 of 48 | -22.5% |
| Speech-language therapy | 92507 | $76.38 | 2021-04-01 | 7 of 39 | +23.9% |
| PT evaluation | 97163 | $73.33 | 2017-01-01 | 29 of 46 | -10.3% |
| OT evaluation | 97167 | $71.16 | 2017-01-01 | 29 of 46 | -13.6% |
| Speech-language evaluation | 92524 | $87.20 | 2014-01-01 | 27 of 44 | -4.5% |
None of these rates carries a 2025 or 2026 effective date. The newest are from 2021, and the speech-language evaluation dates to 2014. Iowa's therapy schedule is therefore a stable one: a practice can build a budget on it with confidence that the numbers will hold, but also without much expectation that they will rise.
Iowa publishes its Medicaid fee schedules by provider type, with separate files for physicians, nurse practitioners, clinics and other provider groups. The rate a therapy claim receives depends on the code, the provider type that bills it and the edition in force on the date of service.
Units and services
Physical and occupational therapy treatment codes such as 97112 and 97533 are timed and billed in 15-minute units; four units make the hourly figures used in this page's comparisons. Speech therapy under 92507 and the evaluations are priced per service, so longer sessions do not raise the payment.
Why the effective dates differ
Each code's rate carries its own effective date. The PT treatment rate dates from 2020, OT and speech treatment from 2021, the PT and OT evaluations from 2017 and the speech-language evaluation from 2014. Iowa updates individual codes rather than reissuing the whole therapy schedule at once, so a practice should check each code it bills rather than assuming one date applies to all.
Iowa's $76.38 rate for 92507 is the standout. It puts Iowa 7th of 39 states, 23.9% above the $61.64 national median, not far behind a top five of Washington ($144.10), Alaska ($118.16), Arizona ($109.12), Texas ($107.78) and North Dakota ($85.24).
Combine that with Iowa's wage data and speech looks even better. Iowa speech-language pathologists earned a median $38.97 an hour in May 2025, well below the national $47.05. A top-ten speech rate paired with a below-median SLP wage gives Iowa pediatric speech practices more room than the state's overall therapy ranking suggests.
What the speech rate means for practices
A per-service speech payment of $76.38 rewards consistent, focused sessions. Because the rate does not rise with session length, the most efficient Iowa speech schedules keep sessions to the length the plan of care needs and fill the day with more patients rather than longer visits. School-age caseloads, where sessions are naturally short and frequent, fit this structure well.
Physical and occupational therapy tell a different story. The PT rate of $90.60 is 5.7% below the median, and occupational therapy under 97533, at $85.68 an hour, is 22.5% below, ranking 37th of 48. Occupational therapy pays less per hour than PT in Iowa, the reverse of the national pattern, where the OT median ($110.60) sits above the PT median ($96.04).
Evaluations are mid-table: $73.33 for a PT evaluation (97163) and $71.16 for an OT evaluation (97167), each 29th of 46. Both are lower than a treatment hour, so an Iowa PT or OT episode earns its return from the treatment visits after intake.
Iowa therapy wages run below the national medians for every role. In May 2025:
- Physical therapists earned a median $46.90 an hour, against $49.40 nationally.
- Occupational therapists earned $43.22, against $48.24.
- Speech-language pathologists earned $38.97, against $47.05.
- Physical therapist assistants earned $29.34, against $32.88.
- Occupational therapy assistants earned $30.84, against $34.76.
Lower wages offset the below-median PT and OT rates:
- Physical therapy (97112): wages take 73.6% of the $90.60 hourly rate, leaving $23.94 an hour after a loaded wage.
- Occupational therapy (97533): wages take 71.7% of the $85.68 hourly rate, leaving $24.25.
OT ends up with a slightly better margin than PT despite the lower rate, because Iowa's OT wage gap to the national median is wider.
Iowa's below-median wages help margins, but they also mean Iowa competes for therapists with higher-paying neighbors. A margin in the mid-$20s per hour gives a practice some room to pay above the local median to recruit and retain staff, particularly in rural counties where a single therapist may serve a wide area.
Assistants are a capacity lever. Physical therapist assistants earn $29.34 and occupational therapy assistants $30.84 at the Iowa median. Where Iowa rules allow assistant-delivered treatment under a therapist's plan of care, assistants extend a scarce therapist's reach to more patients, which matters as much as the margin they create.
Every Iowa therapy code on file, including 92507, 92521 through 92524, 97110, 97112 and the evaluation codes, carries a per-date-of-service limit, and none carries a prior-authorization rule. For billing staff, that means the constraint is how many units can be billed on a single day rather than whether the service is pre-approved.
Scheduling around a daily cap
- Long sessions: check that the planned units fit within the daily limit before the visit, not after the claim is denied.
- Same-day multi-discipline visits: coordinate PT, OT and speech so that each discipline's units stay within its own limit.
- Evaluation days: an evaluation and a treatment on the same date may compete for the same daily allowance.
The absence of prior authorization keeps administrative cost low, which partly offsets the below-median PT and OT rates.
Iowa Medicaid's program list describes the fee-for-service schedules as the floor IA Health Link plans must pay, and the managed-care rule for physical, occupational and speech therapy confirms it: plans must pay at least the published rate. Our data counts 15 plans and programs, including Iowa Total Care, Molina Healthcare of Iowa and Wellpoint Iowa, along with dental plans and PACE programs.
That is a stronger protection than in states where plans negotiate freely. A therapy practice contracting with an Iowa plan can treat the published rate as the minimum and negotiate upward from there. Iowa applies the same floor to physician services, hospital outpatient care and home health, so the published schedules anchor most of the program. The Iowa managed-care page lists the plans on file.
Iowa's therapy rates change code by code, so the signal to watch is a new edition of the provider-type fee schedule that touches therapy codes, or a public notice of a state plan amendment affecting them. Iowa gives public notice of rate changes through state plan amendments; recent notices have covered dental rates, ambulatory surgical center fees and home health intermittent services rather than outpatient therapy.
Home-based therapy is a separate line
Therapy delivered in the home by a home health agency is billed under the home health service line rather than the outpatient therapy schedule. Iowa's public notice for State Plan Amendment IA-25-0010 addressed Medicaid payment rates for home health intermittent services. Practices that deliver therapy in both settings should track the two lines separately, since a change in one does not carry over to the other. Iowa plans must pay at least the published rate for home health as well, so the floor protection applies in both settings.
On physical therapy, Iowa's $90.60 trails Alaska ($176.68), New Mexico ($165.64) and Montana ($147.04), but sits well above New Jersey ($58.80), California ($48.88) and Maine ($46.64). On speech, Iowa is near the top, far above the bottom group of Pennsylvania ($21.70), its neighbor Nebraska ($20.57) and New Hampshire ($19.57). Practices near the eastern border can also compare Illinois therapy rates.
- Budgeting: treat PT, OT and speech as separate lines; speech carries the strongest rate relative to the market.
- Contracting: use the published rate as the minimum in every IA Health Link negotiation.
- Scheduling: build daily unit limits into scheduling templates.
- Monitoring: watch individual code updates, since Iowa revises codes one at a time.
Rates on this page are compiled from official Iowa Medicaid fee schedules, published by provider type. Each rate links to its source document. Hourly figures convert 15-minute units to an hour; ranks compare the same service across states. Wages are May 2025 medians.
This page covers therapy only; the Iowa Medicaid rates hub covers all 105,138 current Iowa Medicaid rates. See the national therapy rates hub, our methodology and pricing.