Therapy Medicaid rates in Montana are among the highest in the country for treatment time. Montana Medicaid pays $147.04 an hour for code 97110, therapeutic exercise, which ranks 3rd of 49 states and is 53.1% above the national median of $96.04. Occupational therapy is even stronger: $197.20 an hour on code 97530, also 3rd, and 78.3% above the median. Only Alaska and New Mexico pay more on either line.
Every rate below is compiled from official Montana Medicaid publications, and each links to its source document. All of the therapy codes discussed here carry a July 1, 2026 effective date, and the Montana Medicaid rates hub covers the rest of the state's schedule.
Montana publishes 97110 at $36.76 per 15-minute unit, with no modifier. Four units make $147.04 for an hour of one-on-one treatment by a physical therapist. For an outpatient clinic, that hourly figure is the number that decides whether a Medicaid caseload is a loss leader or a core business line, and in Montana it is clearly the latter.
The gap to the national median matters most for practices that operate in more than one state. A clinic that bills the same treatment hour in New Jersey, where 97110 converts to $58.80 an hour, earns well under half of what Montana pays. Even against strong states such as Texas at $135.00 and North Dakota at $129.16, Montana is ahead. See the 97110 rate in every state for the full ranking.
Montana's schedule is strongest where time-based treatment is billed and closer to the middle on evaluations.
| Service | Code | Montana rate | Rank | vs national median |
|---|---|---|---|---|
| Physical therapy | 97110 | $147.04 / hour | 3 of 49 | +53.1% |
| Occupational therapy | 97530 | $197.20 / hour | 3 of 48 | +78.3% |
| Speech-language therapy | 92507 | $65.55 | 11 of 39 | +6.3% |
| PT evaluation | 97161 | $84.24 | 19 of 46 | +3.1% |
| OT evaluation | 97165 | $86.54 | 18 of 46 | +5.0% |
| Speech-language evaluation | 92521 | $114.71 | 7 of 44 | +25.6% |
The 97530 occupational therapy rate of $49.30 per unit is the standout. Montana pays it with no modifier, and the hourly figure sits just below New Mexico's $198.64 and far above the national median of $110.60.
Montana Healthcare Programs publishes professional rates in a set of fee schedules updated each July, including the RBRVS workbook for physician-related services and separate mid-level, psychiatrist and other schedules. The therapy rates on this page come from the July 1, 2026 Fee Schedule Updates, published June 30, 2026, which is why every therapy rate shares that effective date.
Units and services
Treatment codes such as 97110 and 97530 are timed and billed in 15-minute units; four units make the hourly figures above. Speech therapy under 92507 and the evaluations are priced per service, so a longer session does not change their payment.
Why the RBRVS method matters
Montana builds many professional rates from relative value units, the same building blocks Medicare uses, multiplied by a Montana conversion factor. When Montana adjusts its conversion factor or updates relative values each July, therapy rates move with the rest of the professional schedule. That is why the annual rate notice, rather than a therapy-specific rule, is the item to watch.
Speech therapy is solid rather than exceptional. Montana pays $65.55 for code 92507, 11th of 39 ranked states, a modest 6.3% above the median of $61.64. The speech-language evaluation on 92521 does better, at $114.71 and 7th of 44, 25.6% above its median.
The PT and OT evaluations are where Montana looks ordinary. The 97161 evaluation pays $84.24 and the OT evaluation on 97165 pays $86.54, each only a few percent above the median. In Montana, revenue in a therapy episode is earned on treatment visits rather than on intake. A practice that sees many evaluations but few follow-up visits will not capture the advantage the treatment rates offer.
Montana's high rates meet below-average wages, which widens margins further. Federal occupational data for May 2025 puts the median Montana physical therapist wage at $43.97 an hour, against $49.40 nationally. Occupational therapists earn $42.79 (US $48.24) and speech-language pathologists $37.86 (US $47.05).
Applied to the hourly Medicaid rate:
- Physical therapy (97110). The PT median wage is 42.5% of the $147.04 rate, leaving a margin of $84.55 an hour after a loaded wage.
- Occupational therapy (97530). The OT median wage is only 30.8% of the $197.20 rate, leaving $136.38 an hour, one of the widest therapy margins in the country.
Assistants follow a slightly different pattern. Montana physical therapist assistants earn a median of $30.12 against $32.88 nationally, but occupational therapy assistants earn $35.00, a little above the US median of $34.76. For Montana OT practices, the case for assistant-delivered treatment rests less on wage savings than it does elsewhere.
These margins still have to absorb documentation time, travel across a large rural state, cancellations and evaluation visits that pay less per hour than treatment. Even so, few states give a therapy practice this much room, and how a practice uses it shapes access for Montana Medicaid members.
Travel and outreach
Montana's distances make home-based and outreach care expensive in unpaid time. A PT margin above $84 an hour can carry a meaningful share of travel, which makes satellite clinics and visiting-therapist models more viable here than in most states.
Recruitment
Below-median wages mean Montana practices often compete with higher-paying states for therapists. The margin gives room to pay above the local median, offer relocation support or reduce productivity targets without pushing Medicaid treatment below break-even.
Telehealth and scheduling
Where Montana policy allows therapy by telehealth, it can extend scarce clinicians across a wide area. Practices should confirm coverage and billing rules for any remote service before relying on it.
The Montana schedule flags prior authorization on most therapy codes:
- 97530 (functional activities): four rules, the most of any therapy code.
- 92507 (speech therapy): three rules.
- 97110 (therapeutic exercise): two rules.
- 97161 to 97163, 97165 to 97167 and the speech evaluations 92521 to 92524: one rule each.
- 97112, 97164 and 97168: none.
No therapy code has a published unit limit. Because 97530 is both Montana's best-paid therapy code and its most authorization-heavy, OT practices should confirm the authorization path before the first treatment claim. For speech practices, the three rules on 92507 deserve similar attention, since ongoing speech treatment is usually the bulk of the caseload.
Montana's published programs are fee-for-service, led by Montana Medicaid and HMK Plus (fee-for-service), so the schedule rate is the rate a therapy practice bills. Montana's coverage data names 17 plans and program arrangements, including Primary Care Montana tiers, Team Care and the Tribal Health Improvement Program, which organize care rather than reprice therapy claims. The Montana managed care page shows how each arrangement is set up.
The move to Primary Care Montana
In July 2026, Montana transitioned Passport to Health, CPC+ and PCMH to a new program, Primary Care Montana (PCMT). PCMT changes how primary care providers are organized and paid, not how therapy claims are priced. Therapy practices may still see referrals and care coordination flow through PCMT primary care providers, so it is worth knowing which tier a patient's primary care practice is in.
The current therapy rates come from the July 1, 2026 Fee Schedule Updates, published June 30, 2026. A related rule, MAR Notice No. 2026-127.1, proposed updating Medicaid provider rates and fee schedules with a 3.39% change and a July 1, 2026 effective date. The prior year's notice, MAR Notice No. 2025-152.1, carried a 3.0% change effective July 1, 2025.
Two other items touch nearby services. MAR Notice No. 2026-525.2, adopted in August 2026, restructured CSCT and HSS rates, and a proposed July 2026 audiology services update affects practices that also bill hearing services. Montana also posted a set of state plan amendments for public comment on June 30, 2026, including a provider fee schedule update page.
Montana is a top-five therapy state on both physical and occupational therapy. Above it are Alaska, at $176.68 an hour for 97110 and $338.72 for OT on 97533, and New Mexico, at $165.64 for 97110. At the bottom, New Jersey ($58.80), California ($48.88) and Maine ($46.64) pay a third or less of Montana's PT hour. Within the Mountain region, Idaho therapy rates sit at the national median, a useful contrast for practices near the state line.
For speech, Washington leads at $144.10 on 92507 while Pennsylvania, Nebraska and New Hampshire sit near $20, so Montana's mid-table position is comfortable.
- Budgeting: model PT at $147.04 an hour and OT at $197.20, then layer in travel and authorization labor.
- Authorization: plan for four rules on 97530 and three on 92507.
- Monitoring: watch each spring's MAR notice for the July rate update.
- Benchmarking: use Montana as a high-end reference when comparing other states' offers.
Rates on this page are compiled from official Montana Healthcare Programs publications, including the July 1, 2026 Fee Schedule Updates. 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.
The Montana Medicaid rates hub covers all 141,671 current Montana Medicaid rates. See the national therapy rates by state for the full picture, our methodology for how 15-minute units become hourly figures, and pricing for full-dataset access.