Indiana Medicaid reimbursement rates
28,364 current fee-for-service and managed-care rates from Indiana Medicaid, across 119 services and 19 programs, normalized by code, provider level and unit. Each links to one of 25 official source documents.
Last retrieved 2026-10-02. History back to 1994-01-01.
- Current rates
- 28,364
- Services
- 119
- Programs
- 19
- Lines with a plan rule
- 20of 22 service lines
By industry
Applied behavior analysis (ABA)Indiana rates, labor costs and changesBehavioral healthIndiana rates, labor costs and changesHome healthIndiana rates, labor costs and changesHome care & personal careIndiana rates, labor costs and changesPrivate duty nursingIndiana rates, labor costs and changesSkilled nursing facilitiesIndiana rates, labor costs and changesHospiceIndiana rates, labor costs and changesIntellectual & developmental disabilitiesIndiana rates, labor costs and changesOutpatient therapy (PT, OT, speech)Indiana rates, labor costs and changes
Indiana 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 assessment by a behavior analyst | ABA / autism services | $23.27 | 15 min | $93.06 | 4 |
| ABA assessment support by a technician | ABA / autism services | $16.04 | 15 min | $64.16 | 2 |
| ABA assessment with 2+ technicians (severe behavior) | ABA / autism services | $26.83 | 15 min | $107.32 | 2 |
| ABA parent and caregiver training | ABA / autism services | $26.54 | 15 min | $94.20 | 3 |
| ABA therapy with 2+ technicians (severe behavior) | ABA / autism services | $26.83 | 15 min | $107.32 | 2 |
| ABA therapy with plan changes by an analyst | ABA / autism services | $23.26 | 15 min | $93.02 | 2 |
| Group ABA parent training (several families) | ABA / autism services | $8.92 | 15 min | $35.66 | 12 |
| Group ABA therapy led by a technician | ABA / autism services | $6.14 | 15 min | $24.56 | 6 |
| Group ABA therapy led by an analyst | ABA / autism services | $8.92 | 15 min | $35.66 | 12 |
| One-on-one ABA therapy by a technician | ABA / autism services | $16.04 | 15 min | $64.16 | 6 |
| Addiction (substance use) counseling | Behavioral health | $36.45 | unit | $58.32 | 12 |
| Certified community behavioral health clinic (CCBHC) rate | Behavioral health | $254.06 | encounter | — | 8 |
| Clubhouse psychosocial rehabilitation (bundled rate) | Behavioral health | $7.92 | bundle | — | 1 |
| Community-based wraparound services | Behavioral health | $28.75 | 15 min | $104.56 | 5 |
| Crisis services bundled payment (mobile or stabilization) | Behavioral health | $489.96 | bundle | — | 4 |
| Hospital outpatient mental health program services | Behavioral health | $90.00 | percent of billed charges | — | 1 |
| Intensive rehabilitative services (adult or child) | Behavioral health | $14.62 | hour | $14.62 | 2 |
| Medication training and support | Behavioral health | $10.99 | 15 min | $43.94 | 12 |
| Mental health assessment (non-physician) | Behavioral health | $189.01 | unit | — | 2 |
| Mental health counseling | Behavioral health | $15.45 | 15 min | $61.80 | 24 |
| Outpatient psychotherapy and diagnostic evaluation | Behavioral health | $98.30 | unit | $169.62 | 74 |
| Psychiatric residential treatment (daily) | Behavioral health | $478.50 | day | — | 10 |
| Psychiatric residential treatment: bed-hold (leave) day | Behavioral health | $239.25 | day | — | 10 |
| Skills training and development | Behavioral health | $17.13 | 15 min | $68.52 | 18 |
| Therapeutic behavioral services | Behavioral health | $20.44 | 15 min | $81.74 | 6 |
| FQHC / RHC visit (PPS or APM rate) | Clinics (FQHC/RHC) | $156.10 | encounter | — | 189 |
| Dental services | Dental | $147.79 | unit | — | 301 |
| Durable medical equipment | Equipment & supplies | $178.89 | unit | $52.48 | 1985 |
| Enteral and parenteral nutrition | Equipment & supplies | $15.31 | day | — | 48 |
| Medical supplies | Equipment & supplies | $32.30 | unit | $32.84 | 811 |
| Orthotics and prosthetics | Equipment & supplies | $545.30 | unit | $116.60 | 892 |
| Adult day services | Other home & community services | $3.74 | 15 min | $13.28 | 55 |
| Adult foster care | Other home & community services | $72.34 | day | — | 15 |
| Assisted living / alternative living services | Other home & community services | $1,580.44 | day | — | 30 |
| Case management / support coordination | Other home & community services | $163.02 | 15 min | $56.84 | 27 |
| Community transition (moving out of an institution) | Other home & community services | $2,500.00 | unit | — | 7 |
| Emergency response system installation | Other home & community services | $54.41 | unit | — | 9 |
| Emergency response system monitoring | Other home & community services | $54.41 | month | — | 9 |
| Home modifications (accessibility) | Other home & community services | $628.00 | unit | — | 9 |
| Home-delivered meals | Other home & community services | $7.76 | unit | — | 5 |
| Nursing respite (RN or LPN) | Other home & community services | $15.40 | 15 min | $61.58 | 18 |
| Other waiver goods and services | Other home & community services | $4,000.00 | unit | — | 9 |
| Respite care (daily) | Other home & community services | $100.00 | day | $43.38 | 13 |
| Respite care (hourly) | Other home & community services | $9.23 | 15 min | $36.92 | 9 |
| Respite in a facility (daily) | Other home & community services | $408.77 | day | — | 1 |
| Specialized medical equipment and supplies | Other home & community services | $8,000.00 | unit | — | 18 |
| Home health agency daily rate / overhead | Home health | $34.50 | day | — | 1 |
| Home health aide visit | Home health | $28.52 | hour | $28.52 | 1 |
| Home health nurse visit (RN or LPN) | Home health | $33.03 | hour | $57.05 | 4 |
| Home health occupational therapy | Home health | $17.21 | 15 min | $68.84 | 1 |
| Home health physical therapy | Home health | $18.63 | 15 min | $74.52 | 1 |
| Home health speech therapy | Home health | $18.78 | 15 min | $75.12 | 1 |
| Hospice nursing home bed-hold (leave) day | Hospice | $147.00 | day | — | 497 |
| Hospice room and board in a nursing home | Hospice | $294.00 | day | — | 497 |
| Inpatient bed-hold (leave) day | Hospital inpatient | $404.43 | day | — | 6 |
| Inpatient capital payment (building and equipment) | Hospital inpatient | $64.50 | day | — | 1 |
| Inpatient DRG pricing input (outlier, cost ratio, stay) | Hospital inpatient | $0.2867 | ratio | — | 184 |
| Inpatient DRG relative weight | Hospital inpatient | $1.54 | weight | — | 1288 |
| Inpatient hospital stay (DRG base rate) | Hospital inpatient | $4,346.00 | percent of billed charges | — | 3 |
| Inpatient hospital stay (per diem) | Hospital inpatient | $1,200.60 | day | — | 5 |
| Inpatient payment adjustment factor | Hospital inpatient | $1.66 | multiplier | — | 9 |
| Inpatient psychiatric stay (per day) | Hospital inpatient | $805.78 | day | — | 7 |
| Inpatient rate add-on (education, wage, directed payment) | Hospital inpatient | $49.02 | discharge | — | 57 |
| Outpatient hospital services (fee schedule) | Hospital outpatient | $56.42 | unit | — | 4511 |
| Outpatient payment adjustment factor | Hospital outpatient | $1.08 | multiplier | — | 8 |
| Surgery center payment group rate | Hospital outpatient | $488.57 | procedure | — | 17 |
| Behavior support services (disability waiver) | IDD services | $18.56 | 15 min | $74.24 | 23 |
| Benefits counseling | IDD services | $50.00 | hour | $50.00 | 6 |
| Community integration / community access (IDD) | IDD services | $26.14 | 15 min | $104.56 | 1 |
| Day habilitation / day program (IDD) | IDD services | $8.30 | hour | $11.34 | 36 |
| Employment exploration | IDD services | $25.36 | hour | $25.36 | 8 |
| ICF/IID bed-hold (leave) day | IDD services | $183.77 | day | — | 410 |
| ICF/IID stay (daily rate) | IDD services | $367.53 | day | — | 411 |
| In-home and community living supports (IDD) | IDD services | $9.45 | 15 min | $37.80 | 2 |
| Prevocational services | IDD services | $5.66 | hour | $5.66 | 18 |
| Remote supports (technology-based supervision) | IDD services | $12.13 | unit | $10.11 | 18 |
| Residential habilitation / group home supports | IDD services | $280.27 | hour | $32.69 | 22 |
| Supported employment (job coaching) | IDD services | $11.91 | 15 min | $47.64 | 2 |
| Supported employment follow-along | IDD services | $52.85 | hour | $52.85 | 7 |
| Clinical lab tests | Lab & pathology | $22.88 | unit | — | 1783 |
| Nursing home statewide price component | Nursing facility | $46.77 | day | — | 4 |
| Nursing home stay (daily rate) | Nursing facility | $309.52 | day | — | 498 |
| Managed care minimum payment (percent of state fees) | Other | $100.00 | percent of IHCP FFS fee schedule | — | 1 |
| Homemaker / housekeeping help | Personal care & attendant | $7.81 | 15 min | $31.22 | 10 |
| Personal care (daily rate) | Personal care & attendant | $36.38 | hour | $36.38 | 8 |
| Personal care / attendant care (hourly) | Personal care & attendant | $8.59 | 15 min | $34.36 | 16 |
| Structured family caregiving (daily) | Personal care & attendant | $99.71 | day | — | 21 |
| Training for unpaid family caregivers | Personal care & attendant | $3,500.00 | 15 min | $63.00 | 16 |
| Pharmacy dispensing fee | Pharmacy | $10.48 | prescription | — | 1 |
| Physician-administered drugs (J-codes) | Pharmacy | $19.77 | unit | — | 1005 |
| Vaccines and immune globulins | Pharmacy | $104.80 | unit | — | 96 |
| Nurse shadowing / home care training | Private duty nursing | $2,000.00 | unit | — | 2 |
| Anesthesia base units (per procedure) | Physician & professional | $7.00 | unit | — | 396 |
| Anesthesia conversion factor | Physician & professional | $19.37 | unit | — | 1 |
| Payment percentage for non-physician practitioners | Physician & professional | $50.00 | percent of IHCP fee schedule max fee | — | 12 |
| Physician and practitioner services (fee schedule) | Physician & professional | $338.72 | unit | $111.86 | 9243 |
| Imaging and radiology | Radiology | $62.03 | unit | — | 1999 |
| Activity therapy | Therapy (PT/OT/speech) | $16.81 | 15 min | $67.24 | 8 |
| Cognitive rehabilitation therapy | Therapy (PT/OT/speech) | $20.80 | unit | — | 3 |
| Nutrition counseling (dietitian) | Therapy (PT/OT/speech) | $29.87 | unit | — | 4 |
| Occupational therapy | Therapy (PT/OT/speech) | $17.99 | unit | $71.96 | 7 |
| Occupational therapy evaluation | Therapy (PT/OT/speech) | $96.07 | unit | — | 4 |
| Orthotic and prosthetic fitting and training | Therapy (PT/OT/speech) | $43.47 | unit | — | 3 |
| Other therapy services | Therapy (PT/OT/speech) | $10.30 | 15 min | $38.80 | 3 |
| Physical therapy | Therapy (PT/OT/speech) | $18.12 | unit | $72.48 | 7 |
| Physical therapy evaluation | Therapy (PT/OT/speech) | $93.69 | unit | — | 4 |
| Speech-language therapy | Therapy (PT/OT/speech) | $18.12 | unit | $72.48 | 6 |
| Swallowing and feeding evaluation | Therapy (PT/OT/speech) | $72.95 | unit | — | 2 |
| Swallowing and feeding therapy | Therapy (PT/OT/speech) | $79.30 | unit | — | 1 |
| Air ambulance transport | Transportation | $4,230.01 | unit | — | 3 |
| Ambulance extras (waiting time, extra attendant, neonatal) | Transportation | $26.66 | unit | — | 5 |
| Ambulance mileage | Transportation | $9.15 | mile | — | 8 |
| Ground ambulance transport | Transportation | $376.64 | unit | — | 6 |
| Non-emergency medical transportation (NEMT) | Transportation | $8.75 | mile | — | 26 |
| Waiver transportation (to community activities) | Transportation | $15.05 | unit | — | 34 |
| Eye exams and vision services | Vision & hearing | $32.91 | unit | — | 117 |
| Eyeglasses and contact lenses | Vision & hearing | $92.16 | unit | — | 98 |
| Hearing aids and hearing services | Vision & hearing | $607.69 | percent of billed charges | — | 17 |
| Hearing tests and audiology services | Vision & hearing | $40.00 | unit | — | 123 |
Most-compared billing codes in Indiana
Where Indiana ranks among states for codes published widely. Rank 1 = highest rate.
| Code | Service | Indiana | All-state median | Rank |
|---|---|---|---|---|
| 10004 | Physician and practitioner services (fee schedule) | $38.95per unit | $35.52 | 5 of 19 |
| 10005 | Physician and practitioner services (fee schedule) | $66.14per unit | $60.63 | 6 of 19 |
| 10006 | Physician and practitioner services (fee schedule) | $45.25per unit | $39.90 | 4 of 19 |
| 10007 | Physician and practitioner services (fee schedule) | $80.65per unit | $76.74 | 8 of 19 |
| 10008 | Physician and practitioner services (fee schedule) | $46.94per unit | $46.94 | 10 of 19 |
| 10009 | Physician and practitioner services (fee schedule) | $98.33per unit | $93.03 | 8 of 19 |
| 10010 | Physician and practitioner services (fee schedule) | $65.32per unit | $65.32 | 10 of 19 |
| 10021 | Physician and practitioner services (fee schedule) | $49.69per unit | $49.77 | 11 of 19 |
| 10030 | Physician and practitioner services (fee schedule) | $121.83per unit | $119.43 | 9 of 19 |
| 10035 | Physician and practitioner services (fee schedule) | $75.99per unit | $70.26 | 6 of 19 |
| 10036 | Physician and practitioner services (fee schedule) | $38.31per unit | $35.41 | 6 of 19 |
| 10060 | Physician and practitioner services (fee schedule) | $97.87per unit | $76.16 | 4 of 19 |
| 10061 | Physician and practitioner services (fee schedule) | $167.76per unit | $129.16 | 4 of 19 |
| 10080 | Physician and practitioner services (fee schedule) | $95.39per unit | $78.73 | 7 of 19 |
| 10081 | Physician and practitioner services (fee schedule) | $153.73per unit | $127.86 | 6 of 19 |
| 10120 | Physician and practitioner services (fee schedule) | $96.39per unit | $77.44 | 5 of 19 |
| 10121 | Physician and practitioner services (fee schedule) | $166.92per unit | $135.29 | 4 of 19 |
| 10140 | Physician and practitioner services (fee schedule) | $108.38per unit | $86.45 | 4 of 19 |
| 10160 | Physician and practitioner services (fee schedule) | $88.27per unit | $69.52 | 3 of 19 |
| 10180 | Physician and practitioner services (fee schedule) | $160.69per unit | $148.10 | 5 of 19 |
| 11000 | Physician and practitioner services (fee schedule) | $24.81per unit | $24.52 | 9 of 19 |
| 11001 | Physician and practitioner services (fee schedule) | $13.46per unit | $12.36 | 9 of 19 |
| 11004 | Physician and practitioner services (fee schedule) | $502.44per unit | $437.21 | 4 of 19 |
| 11005 | Physician and practitioner services (fee schedule) | $674.69per unit | $573.02 | 3 of 19 |
| 11006 | Physician and practitioner services (fee schedule) | $616.78per unit | $542.16 | 4 of 19 |
| 11008 | Physician and practitioner services (fee schedule) | $237.10per unit | $206.56 | 4 of 19 |
| 11010 | Physician and practitioner services (fee schedule) | $248.54per unit | $225.24 | 7 of 19 |
| 11011 | Physician and practitioner services (fee schedule) | $266.27per unit | $229.46 | 8 of 19 |
| 11012 | Physician and practitioner services (fee schedule) | $370.71per unit | $326.26 | 8 of 19 |
| 11042 | Physician and practitioner services (fee schedule) | $54.99per unit | $50.80 | 9 of 19 |
| 11043 | Physician and practitioner services (fee schedule) | $138.66per unit | $134.21 | 9 of 19 |
| 11044 | Physician and practitioner services (fee schedule) | $202.01per unit | $182.12 | 8 of 19 |
| 11055 | Physician and practitioner services (fee schedule) | $14.18per unit | $14.80 | 11 of 19 |
| 11056 | Physician and practitioner services (fee schedule) | $20.38per unit | $20.38 | 10 of 19 |
| 11057 | Physician and practitioner services (fee schedule) | $26.13per unit | $26.13 | 10 of 19 |
| 11102 | Physician and practitioner services (fee schedule) | $34.22per unit | $32.23 | 8 of 19 |
| 11103 | Physician and practitioner services (fee schedule) | $19.78per unit | $18.65 | 8 of 19 |
| 11104 | Physician and practitioner services (fee schedule) | $42.43per unit | $40.43 | 8 of 19 |
| 11105 | Physician and practitioner services (fee schedule) | $22.95per unit | $22.05 | 9 of 19 |
| 11106 | Physician and practitioner services (fee schedule) | $51.11per unit | $49.21 | 9 of 19 |
Managed care in Indiana
16 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 Indiana publish its Medicaid fee schedules?
Indiana publishes rates across 25 official documents (fee schedules, rate notices and bulletins). Every rate on this page links to its source document.
How many Medicaid rates does Indiana publish?
28,364 rates are current across 119 services and 19 programs, with 76,933 versions on record since 1994-01-01.
Do Indiana Medicaid managed-care plans pay the fee schedule?
For 20 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 Indiana rate cardYour codes, what Indiana pays, what plans must pay, and every change in 2026.