Therapy Medicaid rates in Maine are the lowest in the country for physical therapy. MaineCare pays $46.64 an hour for physical therapy, which ranks 49th of 49 states and is 51.4% below the national median of $96.04. The rate is $11.66 per 15-minute unit, billed under HCPCS code S8990 with the GP modifier and effective 2026-01-01.
Maine is also distinctive in how it bills therapy. Rather than pricing each CPT treatment code separately, MaineCare's treatment rates on file sit on a single code, S8990, with a discipline modifier: GP for physical therapy, GO for occupational therapy and GN for speech. At Maine wages, the result is a schedule where an hour of PT or OT treatment pays less than the therapist's median wage. All rates are compiled from official MaineCare publications, and the Maine Medicaid rates hub links each to its source document.
| Service | Code | MaineCare rate | Rank | vs national median |
|---|---|---|---|---|
| Physical therapy | S8990 GP | $46.64/hour | 49 of 49 | -51.4% |
| Occupational therapy | S8990 GO | $45.76/hour | 47 of 48 | -58.6% |
| PT evaluation | 97161 | $68.09 | 33 of 46 | -16.7% |
| OT evaluation | 97165 | $69.87 | 31 of 46 | -15.2% |
| Speech-language evaluation | 92522 GN | $77.95 | 33 of 44 | -14.6% |
All of these rates, and the speech treatment rate, share the 2026-01-01 effective date. The evaluation codes rank in the lower-middle of the table; the PT and OT treatment rates rank at or near the bottom. Speech treatment under S8990 with the GN modifier pays $59.88 an hour.
Billing teams coming from other states should note the coding. MaineCare's PT, OT and speech treatment rates on file attach to S8990, with the GP, GO and GN modifiers setting the discipline and the price: $11.66, $11.44 and $14.97 per 15 minutes respectively. Speech is the best-paid of the three per unit.
The evaluations, by contrast, use the standard CPT evaluation codes. A Maine claim for a new PT patient will therefore mix an S8990 treatment line with a 97161, 97162 or 97163 evaluation line. Getting the modifier right on S8990 matters, because it determines which of the three rates applies.
Why a single treatment code matters
In most states, the therapy schedule prices each CPT treatment code separately, so a session that mixes exercise, neuromuscular work and functional activities produces several lines at several prices. Under S8990, a MaineCare treatment hour pays by discipline and time rather than by technique. That simplifies billing but removes any upside from billing higher-priced techniques: an hour of PT is an hour of PT.
MaineCare pays $11.66 per 15-minute unit of physical therapy, or $46.64 an hour. Maine sits at the bottom of the national table, below California ($48.88) and New Jersey ($58.80). The rate is current, effective 2026-01-01, so it reflects a recent pricing decision rather than a schedule left unrevised for years.
For a physical therapy practice, the practical meaning is simple: a licensed physical therapist delivering MaineCare treatment at the median wage costs more than MaineCare pays for that hour. Every hour of PT treatment for a MaineCare patient is subsidized by something else, whether other payers, evaluation revenue or assistant-delivered care.
Maine therapy wages run below the national medians. In May 2025, physical therapists earned a median $47.94 an hour against $49.40 nationally, occupational therapists $40.53 against $48.24, and speech-language pathologists $39.74 against $47.05. Physical therapist assistants earned $31.85 against $32.88, and occupational therapy assistants $30.90 against $34.76.
Even with lower wages, the treatment rates fall short:
| Service | Rate per hour | Median wage | Wage share of rate |
|---|---|---|---|
| Physical therapy | $46.64 | $47.94 | 146.1% |
| Occupational therapy | $45.76 | $40.53 | 125.9% |
| Speech-language therapy | $59.88 | $39.74 | 94.3% |
After a loaded wage, a PT hour leaves a shortfall of $21.50 and an OT hour a shortfall of $11.85. Speech is the only discipline with a positive margin, at $3.40 an hour. In practice, MaineCare therapy treatment delivered by a licensed therapist at the median wage cannot cover its own labor cost.
Maine practices that continue to serve MaineCare patients do so through a combination of approaches.
Assistant-delivered treatment
Physical therapist assistants earn $31.85 and occupational therapy assistants $30.90 at the Maine median. Both wages are below the PT and OT hourly rates, so assistant-delivered treatment, where Maine rules allow it under a therapist's plan of care, is the main way to bring a MaineCare treatment hour above its labor cost.
Evaluation-weighted care
Because evaluations pay more than an hour of treatment and need no prior authorization, some practices concentrate their MaineCare work on evaluation, plan-of-care development and home programs, with fewer treatment visits.
Limiting MaineCare share
Many practices cap the share of their schedule open to MaineCare patients so that other payers can carry the overhead. That protects the practice, but it also limits access for MaineCare members, which is a policy consequence of the rate level.
Speech-language pathology is the only MaineCare therapy line where treatment covers its labor cost. S8990 with the GN modifier pays $14.97 per 15 minutes, or $59.88 an hour, and Maine speech-language pathologists earned a median $39.74 an hour in May 2025, well below the national $47.05. Wages take 94.3% of the hourly rate, leaving $3.40 an hour after a loaded wage.
What a $3.40 margin means
A positive margin is better than a negative one, but $3.40 an hour does not pay for rent, billing, documentation time or cancellations. Speech practices serving MaineCare patients are closer to break-even than PT and OT practices, not comfortably profitable. The speech-language evaluation under 92522, at $77.95, is the most valuable single speech visit, so a speech episode's economics depend heavily on how efficiently intake is run.
Unit pricing for speech
Because MaineCare prices speech treatment in 15-minute units under S8990 rather than as a flat session, a longer speech session earns proportionally more. That is different from states that pay one amount for a speech session regardless of length. Speech clinicians should document time accurately, since the number of units billed drives the payment.
MaineCare's evaluation rates are low but not extreme. The PT evaluation under 97161 pays $68.09, 16.7% below the $81.72 median; the OT evaluation under 97165 pays $69.87, 15.2% below; and the speech-language evaluation under 92522 pays $77.95, 14.6% below. Relative to the treatment rates, evaluations are where Maine is closest to a typical state, and for many episodes the evaluation will be the single best-paid MaineCare therapy visit.
MaineCare's coverage rules attach authorization to the CPT treatment codes. Codes 97110, 97112, 97530 and 97533 each carry two prior-authorization rules. The evaluation codes 97161 through 97168 carry none, and no listed code has a unit limit. Practices can evaluate new MaineCare patients without a prior approval step, then secure authorization before treatment begins.
MaineCare runs on fee-for-service. Its programs on file, the core MaineCare schedule and waivers listed in the MaineCare Benefits Manual such as Section 19, Section 21 and Section 29, are all fee-for-service. The 7 entities named on file are transportation brokers, community action programs and primary care providers rather than risk-bearing health plans, and no managed-care service-line rule is recorded. The published MaineCare rate is therefore the rate that applies. The Maine managed-care page lists the entities on file.
Two items on Maine's recent agenda touch therapy indirectly. MaineCare opened draft rates for School Health-Related Services to public review and comment, which matters for therapists who work in or contract with schools. And a proposed State Plan Amendment concerns the MaineCare Accountable Communities Program, which could change how some practices are paid for care coordinated through accountable communities. For the core therapy rates, the signal to watch is the next edition of the MaineCare fee schedule.
At the top of the physical therapy table, Alaska pays $176.68 an hour, New Mexico $165.64 and Montana $147.04. On occupational therapy, Maine's $45.76 is above only New Jersey's $31.56, while Alaska pays $338.72. Within New England, practices can compare New Hampshire therapy rates and Massachusetts therapy rates.
- Budgeting: model MaineCare treatment as a cost center for PT and OT, and evaluations as the main revenue line.
- Staffing: use assistant-delivered treatment where permitted to bring treatment above labor cost.
- Billing: apply the GP, GO and GN modifiers to S8990 correctly; the modifier sets the price.
- Monitoring: follow the school-based rate review and future fee schedule editions.
- Benchmarking: compare MaineCare with neighboring New England schedules before setting regional staffing plans.
Rates on this page are compiled from official MaineCare publications, including the MaineCare Fee Schedule. 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 Maine Medicaid rates hub covers all 27,586 current MaineCare rates. See the national therapy rates hub, our methodology and pricing.