Therapy Medicaid rates in Utah sit in the national top ten for physical and occupational therapy. Utah Medicaid pays $119.72 an hour for code 97110, therapeutic exercise, which ranks 7th of 49 states and is 24.7% above the national median of $96.04. Occupational therapy on code 97530 pays $143.64 an hour, 9th of 48.
Every Utah therapy rate in this comparison took effect on July 1, 2026, and every one is above its national median. With therapist wages slightly below national levels, Utah offers some of the widest Medicaid therapy margins in the Mountain region. Every rate below is compiled from official Utah Medicaid publications, and each one links to its source document.
Utah publishes code 97110 at $29.93 per 15-minute unit, with no modifier. Four units make $119.72 an hour, which places Utah behind Alaska, New Mexico, Montana, Texas and North Dakota but ahead of most of the country.
For an outpatient clinic, the PT hour is usually the largest single revenue line, and at this rate a Utah Medicaid caseload can carry its share of overhead rather than needing to be subsidized by commercial patients. Because the rate took effect July 1, 2026, it is current, and budgets built on it will not be undercut by an older figure.
| Service | Code | Utah rate | Rank | vs national median |
|---|---|---|---|---|
| Physical therapy | 97110 | $119.72 / hour | 7 of 49 | +24.7% |
| Occupational therapy | 97530 | $143.64 / hour | 9 of 48 | +29.9% |
| Speech-language therapy | 92507 | $65.22 | 12 of 39 | +5.8% |
| PT evaluation | 97162 | $90.07 | 13 of 46 | +10.2% |
| OT evaluation | 97166 | $92.45 | 12 of 46 | +12.2% |
| Speech-language evaluation | 92521 | $114.07 | 9 of 44 | +24.9% |
Every line is above its national median, with treatment generally stronger than evaluation for PT and OT, and the reverse for speech.
Utah publishes its rates through the Utah Medicaid Coverage and Reimbursement Lookup, which lets a provider download the fee schedule for a given benefit plan and date of service. Rates for the Traditional plan and the Non-Traditional plan are listed separately, so look up the plan your patient is on.
Timed treatment codes
97110, 97112 and 97530 pay per 15-minute unit. Revenue follows documented treatment time, so units per visit is the measure that matters most.
Per-visit codes
Evaluations and 92507 pay once per service, regardless of length. Utah's speech evaluation pays well enough that a thorough evaluation is fully supported by the rate.
Occupational therapy is the strongest line. Code 97530 pays $35.91 per unit, and the OT hour is worth noticeably more than the PT hour, matching the national pattern where the OT median is higher. The OT evaluation on 97166 pays $92.45, 12.2% above the median.
For a practice deciding which discipline to grow, Utah's OT rate combined with a below-median OT wage produces the widest margin on the schedule. Pediatric OT clinics, sensory and fine-motor programs and hand therapy practices all benefit, as long as plan contracts stay close to the schedule.
The PT evaluation on 97162 pays $90.07 and the OT evaluation $92.45, 10.2% and 12.2% above their medians. Those are healthy figures, but they sit lower relative to the market than the treatment codes do.
For PT and OT practices, the practical effect is that treatment days earn a little more per clinician hour than evaluation days. That is a mild difference, not the steep evaluation discount found in some states, and it should not change how a clinic schedules intake. A clinic with frequent new patients still earns well above the national market on each evaluation, and the treatment visits that follow make up the difference. Re-evaluations, which keep a plan of care current and support authorization requests, are equally well supported.
Speech treatment is the one Utah line close to the median. Code 92507 pays $65.22, 12th of 39 ranked states and 5.8% above the national median of $61.64. The speech-language evaluation on 92521 is stronger at $114.07, 24.9% above the median.
It is also the most closely managed. The Utah schedule attaches six prior authorization rules to 92507, while 97110, 97112, the 97161 PT evaluation and the speech evaluation codes 92521 through 92524 carry none. No therapy code has a published unit limit.
For a pediatric speech practice, that combination matters. The evaluation pays well and needs no authorization on the schedule; ongoing treatment pays near the median and needs authorization work on every case. Building authorization tracking into intake is what keeps a Utah speech caseload profitable.
Federal occupational data for May 2025 gives these Utah median hourly wages, with US medians in parentheses:
- Physical therapist: $48.02 ($49.40)
- Occupational therapist: $46.71 ($48.24)
- Speech-language pathologist: $44.02 ($47.05)
- Physical therapist assistant: $29.80 ($32.88)
- Occupational therapy assistant: $31.77 ($34.76)
Every role earns somewhat less than the national median, while the rates are well above it.
The result is wide margins:
- Physical therapy. The PT wage is 57.0% of the $119.72 hourly rate, leaving $51.47 an hour after a loaded wage.
- Occupational therapy. The OT wage is 46.2% of the $143.64 rate, leaving $77.25 an hour.
Those margins leave room for documentation, travel and cancellations, and for paying above the local median to recruit. Assistant wages add further room. Utah physical therapist assistants earn a median of $29.80 and occupational therapy assistants $31.77, both a few dollars under the national medians. Where Utah Medicaid allows assistant-delivered treatment, the margin on a 97110 or 97530 hour widens further.
Utah's therapy rates come from Utah Medicaid (fee-for-service, Traditional plan). The state also runs a Non-Traditional plan, a reduced benefit plan for some adult expansion members, so practices should confirm which benefit plan a member is on before scheduling a course of therapy.
The state's coverage data names 27 plans and program arrangements, including Healthy U, Molina Healthcare of Utah, SelectHealth Community Care and Health Choice Utah, along with integrated plans and county behavioral health organizations. For physical, occupational and speech therapy, Utah's rule is that plans negotiate; the published rate applies out of network. Therapy practices should use the fee schedule as the benchmark when reviewing plan offers: a contract well below a top-ten state rate gives away much of what makes Utah attractive. The Utah managed care page shows how each line is paid.
Some Utah Medicaid members receive services through programs outside the outpatient therapy schedule. The Utah Community Supports 1915(c) waiver serves people with intellectual disabilities or related conditions, the Acquired Brain Injury 1915(c) waiver serves people recovering from brain injuries, and the Division of Services for People with Disabilities publishes its own rate schedule for DSPD service codes. Utah also runs Aging, New Choices and Community Transitions waivers.
Therapists working with these populations should confirm whether a service is billed to a waiver, to DSPD or to the Medicaid therapy schedule before the visit. Brain injury rehabilitation in particular can involve PT, OT and speech together, and the payer for each discipline may differ. Keeping program enrollment on file for each member prevents claims from going to the wrong payer and protects the strong fee-for-service rates for the services they cover.
The most relevant therapy-specific notice is MIB April 2022 22-30 PT/OT Updates, effective April 1, 2022, which updated physical and occupational therapy policy. Utah's July 2026 Medicaid Information Bulletin added billing guidance, telehealth modifier updates and quantity limit updates, all effective July 1, 2026, and a September 2026 bulletin updated telehealth modifiers again. Therapists who deliver any care by telehealth should read both modifier bulletins, and every practice should check the quantity limit update for its codes.
A MIB January 2026 26-05 Chiropractic Services bulletin, effective January 1, 2026, affects a neighboring service line. The current therapy rates all carry a July 1, 2026 effective date.
Utah trails the leaders: Alaska pays $176.68 an hour for 97110, New Mexico $165.64 and Montana $147.04. It is far ahead of the bottom, where New Jersey pays $58.80, California $48.88 and Maine $46.64. Among Mountain neighbors, Nevada and Wyoming are the closest comparisons.
- Contracting. Use the Traditional plan schedule as the anchor with each plan and resist offers that discount a top-ten rate heavily.
- Speech operations. Treat authorization as part of intake for every 92507 case, and track end dates closely.
- Eligibility. Check whether each adult member is on the Traditional or Non-Traditional plan before starting a course of therapy, since benefits differ.
- Benchmarking. Compare your blended Medicaid revenue per therapist hour with the $119.72 PT and $143.64 OT figures; a gap usually points to plan discounts or low units per visit.
The full dataset covers all 44,888 current Utah Medicaid rates, with history back to 1985. See pricing for access.
Rates on this page are compiled from official Utah Medicaid publications, chiefly the Utah Medicaid Coverage and Reimbursement Lookup (PRISM) fee schedule downloads, and each rate links to its source document. For the national overview, see therapy Medicaid rates by state. Every other Utah code is on the Utah Medicaid rates hub, and our methodology explains how units are converted to hourly rates.