Connecticut Medicaid reimbursement rates
45,012 current fee-for-service and managed-care rates from Connecticut Medicaid, across 138 services and 11 programs, normalized by code, provider level and unit. Each links to one of 102 official source documents.
Last retrieved 2026-10-05. History back to 1999-08-01.
- Current rates
- 45,012
- Services
- 138
- Programs
- 11
- Lines with a plan rule
- 0of 22 service lines
By industry
Applied behavior analysis (ABA)Connecticut rates, labor costs and changesBehavioral healthConnecticut rates, labor costs and changesHome healthConnecticut rates, labor costs and changesHome care & personal careConnecticut rates, labor costs and changesPrivate duty nursingConnecticut rates, labor costs and changesSkilled nursing facilitiesConnecticut rates, labor costs and changesHospiceConnecticut rates, labor costs and changesIntellectual & developmental disabilitiesConnecticut rates, labor costs and changesOutpatient therapy (PT, OT, speech)Connecticut rates, labor costs and changes
Connecticut rates by service
The median current rate for each service, like-for-like by unit. Follow a service to compare it with every other state.
| Service | Line | Median rate | Unit | Per hour | Variants |
|---|---|---|---|---|---|
| ABA parent and caregiver training | ABA / autism services | $20.38 | 15 min | $81.52 | 10 |
| ABA therapy with 2+ technicians (severe behavior) | ABA / autism services | $29.33 | 15 min | $117.32 | 7 |
| Group ABA therapy led by an analyst | ABA / autism services | $2.97 | 15 min | $11.88 | 23 |
| One-on-one ABA therapy by a technician | ABA / autism services | $13.46 | 15 min | $53.84 | 12 |
| Addiction (substance use) counseling | Behavioral health | $49.29 | day | $45.26 | 2 |
| Ambulatory withdrawal management (detox) | Behavioral health | $276.69 | — | — | 10 |
| Behavioral health day treatment | Behavioral health | $88.51 | hour | $88.51 | 4 |
| Behavioral health subacute facility day | Behavioral health | $190.33 | day | — | 2 |
| Collaborative care for depression/anxiety in primary care | Behavioral health | $49.68 | — | — | 2 |
| Comprehensive community support services | Behavioral health | $26.31 | 15 min | $105.24 | 1 |
| Crisis intervention (behavioral health) | Behavioral health | $102.26 | 15 min | $91.72 | 13 |
| Intensive outpatient program (behavioral health) | Behavioral health | $173.62 | — | — | 10 |
| Medically supervised inpatient withdrawal (per day) | Behavioral health | $442.70 | — | — | 1 |
| Mental health assessment (non-physician) | Behavioral health | $84.60 | — | — | 26 |
| Mental health counseling | Behavioral health | $21.57 | — | — | 26 |
| Mental health service plan development | Behavioral health | $80.76 | — | — | 48 |
| Outpatient psychotherapy and diagnostic evaluation | Behavioral health | $71.02 | — | $112.76 | 429 |
| Peer support (behavioral health) | Behavioral health | $13.02 | 15 min | $52.08 | 1 |
| Psychiatric partial hospitalization | Behavioral health | $246.36 | — | — | 4 |
| Psychosocial rehabilitation | Behavioral health | $3,530.49 | — | — | 1 |
| Screening, brief intervention and referral (SBIRT) | Behavioral health | $36.00 | — | $192.00 | 8 |
| Skills training and development | Behavioral health | $14.65 | 15 min | $58.60 | 29 |
| SUD residential treatment (per day) | Behavioral health | $49.29 | hour | $45.26 | 2 |
| Supervised living or host home (adults with mental illness) | Behavioral health | $145.00 | — | — | 2 |
| Therapeutic behavioral services | Behavioral health | $25.86 | 15 min | $103.44 | 6 |
| FQHC / RHC visit (PPS or APM rate) | Clinics (FQHC/RHC) | $230.23 | encounter | — | 66 |
| Dental services | Dental | $147.00 | — | — | 679 |
| Durable medical equipment | Equipment & supplies | $123.64 | — | $79.64 | 1546 |
| Enteral and parenteral nutrition | Equipment & supplies | $20.34 | day | — | 18 |
| Medical supplies | Equipment & supplies | $7.66 | — | — | 516 |
| Orthotics and prosthetics | Equipment & supplies | $253.27 | — | $79.64 | 951 |
| Adult day health (medical model) | Other home & community services | $96.98 | — | — | 13 |
| Adult day services | Other home & community services | $81.14 | — | — | 4 |
| Adult foster care | Other home & community services | $75.00 | day | — | 8 |
| Assisted living / alternative living services | Other home & community services | $52.84 | — | — | 17 |
| Assistive technology assessment | Other home & community services | $200.00 | hour | $200.00 | 2 |
| Assistive technology support (training and set-up) | Other home & community services | $2,000.00 | — | — | 10 |
| Automated medication dispenser monthly service | Other home & community services | $157.40 | month | — | 1 |
| Brain injury rehabilitation services (Medicaid program) | Other home & community services | $27.72 | 15 min | $82.36 | 3 |
| Case management / support coordination | Other home & community services | $16.19 | month | $62.24 | 27 |
| Community residential services for people with a brain injury | Other home & community services | $209.95 | day | — | 1 |
| Community transition (moving out of an institution) | Other home & community services | $2,000.00 | — | — | 1 |
| Emergency response system installation | Other home & community services | $36.06 | — | — | 6 |
| Emergency response system monitoring | Other home & community services | $60.09 | — | — | 14 |
| Family and peer mentoring | Other home & community services | $16.13 | 15 min | $20.52 | 6 |
| Family caregiver training and support | Other home & community services | $53.38 | 15 min | $100.00 | 6 |
| HCBS waiver service (other) | Other home & community services | $46.90 | — | $64.64 | 10 |
| Health care assessment (monthly, disability waiver) | Other home & community services | $66.00 | — | — | 3 |
| Home modifications (accessibility) | Other home & community services | $10,050.00 | Per Unit | — | 6 |
| Home visit by medical personnel | Other home & community services | $28.33 | 15 min | $113.32 | 1 |
| Home-delivered meals | Other home & community services | $11.57 | day | — | 16 |
| Independent living assistance | Other home & community services | $69.19 | — | — | 3 |
| Independent living skills training | Other home & community services | $12.05 | 15 min | $48.20 | 5 |
| Interpreter services | Other home & community services | $68.98 | 15 min | $80.00 | 12 |
| Money management support | Other home & community services | $5.28 | — | — | 1 |
| Nurse wellness counseling visit | Other home & community services | $71.02 | — | $71.02 | 4 |
| Nursing assessment | Other home & community services | $98.53 | hour | $98.53 | 1 |
| Nursing respite (RN or LPN) | Other home & community services | $9.08 | 15 min | $36.32 | 1 |
| Prescribed pediatric extended care (medical day care) | Other home & community services | $198.84 | day | — | 1 |
| Respite care (daily) | Other home & community services | $377.12 | day | — | 34 |
| Respite care (hourly) | Other home & community services | $24.14 | hour | $23.56 | 56 |
| Self-direction coaching / supports broker | Other home & community services | $38.21 | — | $40.42 | 12 |
| Service planning meeting | Other home & community services | $243.66 | — | $235.04 | 11 |
| Specialized medical equipment and supplies | Other home & community services | $5,500.00 | — | — | 2 |
| Transitional care coordination (children's waiver) | Other home & community services | $150.21 | — | — | 1 |
| Vehicle modifications | Other home & community services | $10,100.00 | Per Unit | — | 3 |
| Home health aide visit | Home health | $37.41 | visit | — | 1 |
| Home health nurse visit (RN or LPN) | Home health | $54.12 | 15 min | $243.28 | 9 |
| Home health occupational therapy | Home health | $24.63 | 15 min | $97.88 | 3 |
| Home health physical therapy | Home health | $33.55 | 15 min | $116.36 | 3 |
| Home health speech therapy | Home health | $26.52 | 15 min | $102.30 | 3 |
| Home health therapy evaluation visit | Home health | $86.58 | visit | — | 3 |
| RN management of the home care plan | Home health | $24.63 | 15 min | $98.52 | 1 |
| Hospice continuous home care (hourly) | Hospice | $74.87 | — | — | 6 |
| Hospice end-of-life visit add-on (per hour) | Hospice | $18.72 | — | — | 12 |
| Hospice routine home care (daily) | Hospice | $215.29 | — | — | 12 |
| Inpatient DRG pricing input (outlier, cost ratio, stay) | Hospital inpatient | $71,509.36 | — | — | 1466 |
| Inpatient DRG relative weight | Hospital inpatient | $1.41 | — | — | 1464 |
| Inpatient hospital stay (DRG base rate) | Hospital inpatient | $1,331.14 | — | — | 370 |
| Inpatient hospital stay (per diem) | Hospital inpatient | $950.89 | — | — | 3 |
| Inpatient psychiatric stay (per day) | Hospital inpatient | $951.97 | day | — | 34 |
| Organ acquisition fee (per organ) | Hospital inpatient | $115,321.00 | — | — | 3 |
| Outpatient hospital APC relative weight | Hospital outpatient | $19.89 | — | — | 6650 |
| Outpatient hospital conversion factor (APC/EAPG) | Hospital outpatient | $87.88 | — | — | 76 |
| Outpatient hospital services (fee schedule) | Hospital outpatient | $1,585.19 | — | $181.34 | 7418 |
| Surgery center facility fee (per procedure) | Hospital outpatient | $415.75 | — | — | 4 |
| Additional residential staffing | IDD services | $119,884.00 | — | $28.16 | 15 |
| Behavior support services (disability waiver) | IDD services | $132.40 | hour | $132.40 | 3 |
| Day habilitation / day program (IDD) | IDD services | $52.28 | day | $23.17 | 198 |
| Employment exploration | IDD services | $90.48 | hour | $82.96 | 8 |
| ICF/IID stay (daily rate) | IDD services | $723.19 | day | — | 58 |
| In-home and community living supports (IDD) | IDD services | $14,712.00 | hour | $25.88 | 21 |
| Job development and self-employment outcome payments | IDD services | $2,213.00 | hour | $89.75 | 17 |
| Prevocational services | IDD services | $38.75 | hour | $38.75 | 1 |
| Remote supports (technology-based supervision) | IDD services | $12.38 | hour | $12.32 | 22 |
| Residential habilitation / group home supports | IDD services | $122,364.00 | — | — | 64 |
| Residential habilitation room and board fee | IDD services | $49.47 | day | — | 722 |
| Shared living / host home / family model | IDD services | $3,388.50 | — | — | 44 |
| Supported employment (job coaching) | IDD services | $88.96 | hour | $38.75 | 42 |
| Clinical lab tests | Lab & pathology | $18.75 | — | — | 1865 |
| Nursing home stay (daily rate) | Nursing facility | $107.21 | — | — | 1 |
| Birth center delivery facility rate | Other | $4,284.00 | — | — | 2 |
| Doula support during labor and delivery | Other | $450.00 | day | — | 2 |
| Early intervention services for infants and toddlers | Other | $17.88 | 15 min | $71.50 | 2 |
| Companion care | Personal care & attendant | $15.69 | 15 min | $18.25 | 14 |
| Home health aide or nurse aide care (hourly) | Personal care & attendant | $8.23 | 15 min | $32.92 | 1 |
| Homemaker / housekeeping help | Personal care & attendant | $5.51 | 15 min | $21.22 | 10 |
| Personal care (daily rate) | Personal care & attendant | $22.61 | day | — | 15 |
| Personal care / attendant care (hourly) | Personal care & attendant | $10.50 | 15 min | $25.52 | 27 |
| Physician-administered drugs (J-codes) | Pharmacy | $11.05 | — | — | 891 |
| Nurse shadowing / home care training | Private duty nursing | $23.80 | 15 min | $95.20 | 1 |
| Private duty nursing (hourly shifts) | Private duty nursing | $49.67 | hour | $49.67 | 16 |
| Waiver nursing (RN or LPN, by the 15 minutes) | Private duty nursing | $24.08 | 15 min | $96.32 | 10 |
| Physician and practitioner services (fee schedule) | Physician & professional | $300.04 | — | $76.76 | 14602 |
| Imaging and radiology | Radiology | $55.24 | — | — | 3689 |
| Cognitive rehabilitation therapy | Therapy (PT/OT/speech) | $18.73 | 15 min | $74.92 | 11 |
| Nutrition counseling (dietitian) | Therapy (PT/OT/speech) | $22.34 | — | $95.90 | 7 |
| Occupational therapy | Therapy (PT/OT/speech) | $24.80 | 15 min | $99.18 | 6 |
| Occupational therapy evaluation | Therapy (PT/OT/speech) | $63.88 | — | — | 15 |
| Orthotic and prosthetic fitting and training | Therapy (PT/OT/speech) | $28.96 | 15 min | $115.84 | 12 |
| Other therapy services | Therapy (PT/OT/speech) | $387.21 | — | — | 1 |
| Physical therapy | Therapy (PT/OT/speech) | $22.46 | 15 min | $89.84 | 9 |
| Physical therapy evaluation | Therapy (PT/OT/speech) | $62.18 | — | — | 15 |
| Respiratory therapy at home | Therapy (PT/OT/speech) | $17.00 | 15 min | $68.00 | 3 |
| Speech-generating device evaluation | Therapy (PT/OT/speech) | $84.84 | — | — | 2 |
| Speech-generating device therapy | Therapy (PT/OT/speech) | $70.02 | — | — | 3 |
| Speech-language evaluation | Therapy (PT/OT/speech) | $60.00 | — | — | 15 |
| Speech-language therapy | Therapy (PT/OT/speech) | $50.88 | — | — | 4 |
| Swallowing and feeding evaluation | Therapy (PT/OT/speech) | $79.37 | — | — | 4 |
| Swallowing and feeding therapy | Therapy (PT/OT/speech) | $71.96 | — | — | 3 |
| Air ambulance transport | Transportation | $3,070.00 | — | — | 1 |
| Ambulance mileage | Transportation | $7.06 | mile | — | 5 |
| Escort / attendant on waiver transportation | Transportation | $23.22 | year | — | 44 |
| Ground ambulance transport | Transportation | $171.70 | — | — | 9 |
| Non-emergency medical transportation (NEMT) | Transportation | $0.91 | mile | — | 5 |
| Waiver transportation (to community activities) | Transportation | $24.24 | — | — | 41 |
| Eyeglasses and contact lenses | Vision & hearing | $43.08 | — | — | 89 |
| Hearing aids and hearing services | Vision & hearing | $410.00 | — | — | 47 |
Most-compared billing codes in Connecticut
Where Connecticut ranks among states for codes published widely. Rank 1 = highest rate.
| Code | Service | Connecticut | All-state median | Rank |
|---|---|---|---|---|
| 10005 | Physician and practitioner services (fee schedule) | $82.89 | $79.38 | 17 of 35 |
| 10006 | Physician and practitioner services (fee schedule) | $48.10 | $44.97 | 11 of 35 |
| 10007 | Physician and practitioner services (fee schedule) | $190.57 | $150.61 | 14 of 35 |
| 10008 | Physician and practitioner services (fee schedule) | $115.40 | $73.48 | 10 of 35 |
| 10009 | Physician and practitioner services (fee schedule) | $341.89 | $180.34 | 10 of 35 |
| 10010 | Physician and practitioner services (fee schedule) | $191.53 | $102.56 | 10 of 35 |
| 10021 | Physician and practitioner services (fee schedule) | $81.78 | $67.99 | 10 of 35 |
| 10030 | Physician and practitioner services (fee schedule) | $506.95 | $162.47 | 8 of 35 |
| 10060 | Physician and practitioner services (fee schedule) | $79.97 | $81.94 | 20 of 35 |
| 10061 | Physician and practitioner services (fee schedule) | $133.76 | $148.21 | 21 of 35 |
| 10080 | Physician and practitioner services (fee schedule) | $154.87 | $100.82 | 12 of 35 |
| 10081 | Physician and practitioner services (fee schedule) | $212.90 | $159.09 | 14 of 35 |
| 10120 | Physician and practitioner services (fee schedule) | $95.05 | $89.53 | 16 of 35 |
| 10121 | Physician and practitioner services (fee schedule) | $165.54 | $159.38 | 15 of 35 |
| 10140 | Physician and practitioner services (fee schedule) | $106.13 | $100.20 | 15 of 35 |
| 10160 | Physician and practitioner services (fee schedule) | $81.47 | $79.28 | 17 of 35 |
| 10180 | Physician and practitioner services (fee schedule) | $165.58 | $154.29 | 15 of 35 |
| 11000 | Physician and practitioner services (fee schedule) | $36.55 | $35.27 | 16 of 35 |
| 11001 | Physician and practitioner services (fee schedule) | $16.82 | $16.01 | 17 of 35 |
| 11004 | Physician and practitioner services (fee schedule) | $348.23 | $437.26 | 28 of 35 |
| 11005 | Physician and practitioner services (fee schedule) | $475.97 | $593.90 | 26 of 35 |
| 11006 | Physician and practitioner services (fee schedule) | $431.30 | $548.28 | 28 of 35 |
| 11008 | Physician and practitioner services (fee schedule) | $167.80 | $211.81 | 26 of 35 |
| 11010 | Physician and practitioner services (fee schedule) | $277.25 | $259.67 | 15 of 35 |
| 11011 | Physician and practitioner services (fee schedule) | $406.03 | $291.14 | 8 of 35 |
| 11012 | Physician and practitioner services (fee schedule) | $525.06 | $393.77 | 8 of 35 |
| 11042 | Physician and practitioner services (fee schedule) | $80.89 | $76.21 | 15 of 35 |
| 11043 | Physician and practitioner services (fee schedule) | $188.39 | $158.67 | 11 of 35 |
| 11044 | Physician and practitioner services (fee schedule) | $251.00 | $213.31 | 12 of 35 |
| 11055 | Physician and practitioner services (fee schedule) | $44.06 | $20.00 | 11 of 35 |
| 11056 | Physician and practitioner services (fee schedule) | $51.08 | $29.68 | 11 of 35 |
| 11057 | Physician and practitioner services (fee schedule) | $55.54 | $38.94 | 11 of 35 |
| 11102 | Physician and practitioner services (fee schedule) | $80.50 | $65.28 | 9 of 35 |
| 11103 | Physician and practitioner services (fee schedule) | $40.19 | $32.73 | 10 of 35 |
| 11104 | Physician and practitioner services (fee schedule) | $100.42 | $77.06 | 9 of 35 |
| 11105 | Physician and practitioner services (fee schedule) | $48.39 | $38.77 | 11 of 35 |
| 11106 | Physician and practitioner services (fee schedule) | $96.13 | $95.36 | 17 of 35 |
| 11107 | Physician and practitioner services (fee schedule) | $57.04 | $46.36 | 10 of 35 |
| 11300 | Physician and practitioner services (fee schedule) | $61.79 | $42.15 | 11 of 35 |
| 11301 | Physician and practitioner services (fee schedule) | $75.04 | $55.47 | 11 of 35 |
Managed care in Connecticut
9 plans on record, 0 state-directed payment records.
Who sets the rate, line by line →Recent rate changes and notices
Frequently asked questions
Where does Connecticut publish its Medicaid fee schedules?
Connecticut publishes rates across 102 official documents (fee schedules, rate notices and bulletins). Every rate on this page links to its source document.
How many Medicaid rates does Connecticut publish?
45,012 rates are current across 138 services and 11 programs, with 103,148 versions on record since 1999-08-01.
Do Connecticut Medicaid managed-care plans pay the fee schedule?
For 0 of 22 service lines, plan contracts or state law set a rule plans must follow (a floor, a state-set rate or a required pass-through). For the rest, plans negotiate. See the managed-care page for each line's rule and citation.
Other states
Your Connecticut rate cardYour codes, what Connecticut pays, what plans must pay, and every change in 2026.