Nebraska Medicaid reimbursement rates
40,192 current fee-for-service and managed-care rates from Nebraska Medicaid, across 111 services and 10 programs, normalized by code, provider level and unit. Each links to one of 56 official source documents. Nebraska pays the highest rate of any state we cover for 11004, 11006, 11043.
Last retrieved 2026-10-02. History back to 2021-01-01.
- Current rates
- 40,192
- Services
- 111
- Programs
- 10
- Lines with a plan rule
- 9of 22 service lines
By industry
Applied behavior analysis (ABA)Nebraska rates, labor costs and changesBehavioral healthNebraska rates, labor costs and changesHome healthNebraska rates, labor costs and changesHome care & personal careNebraska rates, labor costs and changesPrivate duty nursingNebraska rates, labor costs and changesSkilled nursing facilitiesNebraska rates, labor costs and changesHospiceNebraska rates, labor costs and changesIntellectual & developmental disabilitiesNebraska rates, labor costs and changesOutpatient therapy (PT, OT, speech)Nebraska rates, labor costs and changes
Nebraska 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 | $38.16 | 15 min | $152.64 | 10 |
| ABA assessment support by a technician | ABA / autism services | $25.88 | 15 min | $103.52 | 9 |
| ABA parent and caregiver training | ABA / autism services | $26.06 | 15 min | $104.24 | 6 |
| ABA therapy with plan changes by an analyst | ABA / autism services | $22.72 | 15 min | $90.88 | 6 |
| Group ABA therapy led by a technician | ABA / autism services | $7.49 | 15 min | $29.96 | 6 |
| Group ABA therapy led by an analyst | ABA / autism services | $12.05 | 15 min | $48.20 | 6 |
| One-on-one ABA therapy by a technician | ABA / autism services | $18.70 | 15 min | $74.80 | 6 |
| Behavioral health services (fee schedule) | Behavioral health | $98.27 | hour | $59.93 | 127 |
| Certified community behavioral health clinic (CCBHC) rate | Behavioral health | $233.58 | — | — | 7 |
| Mental health assessment (non-physician) | Behavioral health | $158.29 | — | — | 3 |
| Multisystemic therapy for youth | Behavioral health | $50.89 | 15 min | $203.56 | 2 |
| Outpatient psychotherapy and diagnostic evaluation | Behavioral health | $120.79 | — | $179.22 | 714 |
| Psychiatric residential treatment (daily) | Behavioral health | $283.19 | day | — | 10 |
| Skills training and development | Behavioral health | $10.09 | 15 min | $40.36 | 2 |
| Therapeutic behavioral services (daily rate) | Behavioral health | $225.87 | day | — | 1 |
| FQHC / RHC visit (PPS or APM rate) | Clinics (FQHC/RHC) | $232.24 | — | — | 110 |
| FQHC dental visit (PPS or APM rate) | Clinics (FQHC/RHC) | $257.07 | — | — | 63 |
| Dental services | Dental | $109.58 | — | — | 200 |
| Durable medical equipment | Equipment & supplies | $143.12 | — | $50.08 | 1337 |
| Enteral and parenteral nutrition | Equipment & supplies | $10.48 | day | — | 55 |
| Medical supplies | Equipment & supplies | $9.17 | — | — | 506 |
| Orthotics and prosthetics | Equipment & supplies | $324.07 | — | $66.96 | 857 |
| Adult day health (medical model) | Other home & community services | $47.38 | Day (6+ Hrs) | $13.53 | 4 |
| Adult day services | Other home & community services | $10.84 | hour | $10.84 | 3 |
| Assisted living / alternative living services | Other home & community services | $1,664.00 | month | — | 40 |
| Case management / support coordination | Other home & community services | $89.58 | — | — | 1 |
| Chore services (heavy cleaning, yard work, pest control) | Other home & community services | $50.00 | hour | $50.00 | 3 |
| Community integration (older adults / disability waivers) | Other home & community services | $22.98 | hour | $22.98 | 2 |
| Community transition (moving out of an institution) | Other home & community services | $1,091.46 | Occurance | — | 2 |
| Emergency response system monitoring | Other home & community services | $55.00 | Occurance | — | 1 |
| Family and peer mentoring | Other home & community services | $50.00 | hour | $50.00 | 1 |
| Home-delivered meals | Other home & community services | $6.44 | Occurance | — | 1 |
| Independent living skills training | Other home & community services | $8.00 | hour | $8.00 | 3 |
| Interpreter services | Other home & community services | $13.50 | 15 min | $54.00 | 2 |
| Respite care (daily) | Other home & community services | $99.45 | day | — | 12 |
| Respite care (hourly) | Other home & community services | $14.97 | hour | $14.97 | 28 |
| Home health agency daily rate / overhead | Home health | $1,339.70 | 1 | — | 4 |
| Home health aide visit | Home health | $61.89 | visit | — | 1 |
| Home health nurse visit (RN or LPN) | Home health | $100.21 | visit | — | 2 |
| Home health occupational therapy | Home health | $116.38 | visit | — | 1 |
| Home health physical therapy | Home health | $116.38 | visit | — | 1 |
| Home health speech therapy | Home health | $116.38 | visit | — | 1 |
| Hospice room and board in a nursing home | Hospice | $305.11 | — | — | 4524 |
| Hospital administrative (non-acute) day | Hospital inpatient | $296.01 | — | — | 1 |
| IHS / tribal hospital stay (all-inclusive daily rate) | Hospital inpatient | $5,707.00 | day | — | 5 |
| Inpatient capital payment (building and equipment) | Hospital inpatient | $50.00 | day | — | 37 |
| Inpatient DRG pricing input (outlier, cost ratio, stay) | Hospital inpatient | $0.3659 | — | — | 74 |
| Inpatient DRG relative weight | Hospital inpatient | $1.64 | — | — | 1356 |
| Inpatient hospital stay (DRG base rate) | Hospital inpatient | $8,556.00 | — | — | 37 |
| Inpatient hospital stay (per diem) | Hospital inpatient | $2,402.31 | day | — | 138 |
| Inpatient payment adjustment factor | Hospital inpatient | $0.0285 | — | — | 9 |
| Inpatient psychiatric stay (per day) | Hospital inpatient | $877.34 | — | — | 5 |
| Inpatient rate add-on (education, wage, directed payment) | Hospital inpatient | $56.50 | — | — | 18 |
| EAPG relative weight (outpatient hospital or surgery center) | Hospital outpatient | $0.459 | — | — | 611 |
| IHS / tribal outpatient visit (all-inclusive rate) | Hospital outpatient | $826.00 | — | — | 20 |
| Outpatient hospital (percent of charges or cost) | Hospital outpatient | $48.00 | % | — | 100 |
| Outpatient hospital conversion factor (APC/EAPG) | Hospital outpatient | $794.17 | — | — | 51 |
| Surgery center facility fee (per procedure) | Hospital outpatient | $413.00 | — | — | 3 |
| Surgery center payment group rate | Hospital outpatient | $891.00 | — | — | 9 |
| Benefits counseling | IDD services | $44.87 | hour | $44.87 | 1 |
| Community integration / community access (IDD) | IDD services | $19.53 | hour | $19.53 | 11 |
| Day habilitation / day program (IDD) | IDD services | $19.53 | hour | $19.53 | 17 |
| Employment exploration | IDD services | $22.39 | hour | $22.39 | 1 |
| In-home and community living supports (IDD) | IDD services | $20.97 | hour | $20.97 | 14 |
| Prevocational services | IDD services | $22.39 | hour | $22.39 | 3 |
| Residential habilitation / group home supports | IDD services | $371.36 | day | — | 10 |
| Shared living / host home / family model | IDD services | $312.25 | day | — | 10 |
| Supported employment (job coaching) | IDD services | $33.62 | hour | $33.62 | 5 |
| Supported employment follow-along | IDD services | $44.64 | hour | $44.64 | 4 |
| Clinical lab tests | Lab & pathology | $16.80 | — | — | 2777 |
| Nursing home bed-hold (leave) day | Nursing facility | $1,087.91 | — | — | 8 |
| Nursing home daily add-on (ventilator, trach, insurance) | Nursing facility | $34.93 | mile | $41.53 | 5 |
| Nursing home stay (daily rate) | Nursing facility | $321.17 | — | — | 4526 |
| Specialty nursing home daily rate (pediatric or IDD class) | Nursing facility | $1,087.91 | — | — | 8 |
| Swing-bed stay (hospital bed used for nursing-home care) | Nursing facility | $296.01 | — | — | 1 |
| Directed payment program total (CMS-approved amount) | Other | $23,485,412.00 | up to $1,410,710,373 | — | 3 |
| Directed payment uniform increase (required MCO uplift) | Other | $155.35 | 499.64% increase per inpatient critical access hospital (CAH) claim, 268.39% increase per other (non-CAH) inpatient claim, 174.52% increase per outpatient CAH claim, and 136.18% increase per other outpatient hospital claim. | — | 6 |
| Managed care capitation rate | Other | $900.99 | member month | — | 156 |
| Companion care | Personal care & attendant | $12.67 | hour | $12.67 | 24 |
| Home health aide or nurse aide care (hourly) | Personal care & attendant | $25.32 | hour | $25.32 | 1 |
| Homemaker / housekeeping help | Personal care & attendant | $17.63 | hour | $17.63 | 2 |
| Personal care / attendant care (hourly) | Personal care & attendant | $21.00 | hour | $24.50 | 21 |
| Training for unpaid family caregivers | Personal care & attendant | $500.00 | Per Year | — | 1 |
| Physician-administered drugs (J-codes) | Pharmacy | $11.55 | — | — | 1019 |
| Private duty nursing (hourly shifts) | Private duty nursing | $36.82 | hour | $40.75 | 9 |
| Waiver nursing (RN or LPN, by the 15 minutes) | Private duty nursing | $4.90 | unit | — | 2 |
| Anesthesia base units (per procedure) | Physician & professional | $89.76 | — | — | 1100 |
| Anesthesia conversion factor | Physician & professional | $1.72 | — | — | 5 |
| Physician and practitioner services (fee schedule) | Physician & professional | $385.32 | — | $131.60 | 17255 |
| Imaging and radiology | Radiology | $106.76 | — | — | 1795 |
| Cognitive rehabilitation therapy | Therapy (PT/OT/speech) | $30.12 | 15 min | $120.48 | 6 |
| Nutrition counseling (dietitian) | Therapy (PT/OT/speech) | $31.90 | 15 min | $127.60 | 6 |
| Occupational therapy | Therapy (PT/OT/speech) | $27.42 | 15 min | $109.68 | 3 |
| Occupational therapy evaluation | Therapy (PT/OT/speech) | $87.74 | — | — | 8 |
| Orthotic and prosthetic fitting and training | Therapy (PT/OT/speech) | $40.57 | 15 min | $162.28 | 6 |
| Physical therapy | Therapy (PT/OT/speech) | $27.42 | 15 min | $109.68 | 6 |
| Physical therapy evaluation | Therapy (PT/OT/speech) | $87.74 | — | — | 8 |
| Speech-generating device evaluation | Therapy (PT/OT/speech) | $91.03 | — | — | 2 |
| Speech-generating device therapy | Therapy (PT/OT/speech) | $45.51 | — | — | 2 |
| Speech-language evaluation | Therapy (PT/OT/speech) | $131.09 | — | — | 8 |
| Speech-language therapy | Therapy (PT/OT/speech) | $34.96 | — | — | 6 |
| Swallowing and feeding evaluation | Therapy (PT/OT/speech) | $77.54 | — | — | 6 |
| Swallowing and feeding therapy | Therapy (PT/OT/speech) | $60.32 | — | — | 6 |
| Air ambulance transport | Transportation | $1,519.95 | — | — | 2 |
| Ambulance mileage | Transportation | $12.90 | mile | — | 3 |
| Escort / attendant on waiver transportation | Transportation | $4.46 | 15 min | $17.84 | 4 |
| Ground ambulance transport | Transportation | $387.24 | — | — | 7 |
| Non-emergency medical transportation (NEMT) | Transportation | $7.73 | mile | — | 10 |
| Waiver transportation (to community activities) | Transportation | $2.07 | mile | — | 14 |
| Eyeglasses and contact lenses | Vision & hearing | $36.37 | — | — | 71 |
| Hearing aids and hearing services | Vision & hearing | $803.37 | — | — | 54 |
Most-compared billing codes in Nebraska
Where Nebraska ranks among states for codes published widely. Rank 1 = highest rate.
| Code | Service | Nebraska | All-state median | Rank |
|---|---|---|---|---|
| 10004 | Physician and practitioner services (fee schedule) | $41.49 | $35.52 | 4 of 19 |
| 10005 | Physician and practitioner services (fee schedule) | $100.77 | $60.63 | 3 of 19 |
| 10006 | Physician and practitioner services (fee schedule) | $47.42 | $39.90 | 3 of 19 |
| 10007 | Physician and practitioner services (fee schedule) | $118.56 | $76.74 | 4 of 19 |
| 10008 | Physician and practitioner services (fee schedule) | $59.28 | $46.94 | 5 of 19 |
| 10009 | Physician and practitioner services (fee schedule) | $142.27 | $93.03 | 4 of 19 |
| 10010 | Physician and practitioner services (fee schedule) | $71.13 | $65.32 | 8 of 19 |
| 10021 | Physician and practitioner services (fee schedule) | $53.00 | $49.77 | 8 of 19 |
| 10030 | Physician and practitioner services (fee schedule) | $148.20 | $119.43 | 3 of 19 |
| 10035 | Physician and practitioner services (fee schedule) | $112.63 | $70.26 | 4 of 19 |
| 10036 | Physician and practitioner services (fee schedule) | $53.35 | $35.41 | 4 of 19 |
| 10060 | Physician and practitioner services (fee schedule) | $59.28 | $76.16 | 15 of 19 |
| 10061 | Physician and practitioner services (fee schedule) | $124.48 | $129.16 | 11 of 19 |
| 10080 | Physician and practitioner services (fee schedule) | $44.23 | $78.73 | 16 of 19 |
| 10081 | Physician and practitioner services (fee schedule) | $78.23 | $127.86 | 17 of 19 |
| 10120 | Physician and practitioner services (fee schedule) | $77.06 | $77.44 | 11 of 19 |
| 10121 | Physician and practitioner services (fee schedule) | $159.38 | $135.29 | 5 of 19 |
| 10140 | Physician and practitioner services (fee schedule) | $57.27 | $86.45 | 17 of 19 |
| 10160 | Physician and practitioner services (fee schedule) | $45.51 | $69.52 | 17 of 19 |
| 10180 | Physician and practitioner services (fee schedule) | $153.37 | $148.10 | 7 of 19 |
| 11000 | Physician and practitioner services (fee schedule) | $11.83 | $24.52 | 19 of 19 |
| 11001 | Physician and practitioner services (fee schedule) | $21.71 | $12.36 | 2 of 19 |
| 11004 | Physician and practitioner services (fee schedule) | $659.48 | $437.21 | 1 of 19 |
| 11005 | Physician and practitioner services (fee schedule) | $180.50 | $573.02 | 17 of 19 |
| 11006 | Physician and practitioner services (fee schedule) | $829.92 | $542.16 | 1 of 19 |
| 11008 | Physician and practitioner services (fee schedule) | $68.05 | $206.56 | 18 of 19 |
| 11010 | Physician and practitioner services (fee schedule) | $366.72 | $225.24 | 2 of 19 |
| 11011 | Physician and practitioner services (fee schedule) | $137.59 | $229.46 | 18 of 19 |
| 11012 | Physician and practitioner services (fee schedule) | $147.96 | $326.26 | 18 of 19 |
| 11042 | Physician and practitioner services (fee schedule) | $102.20 | $50.80 | 4 of 19 |
| 11043 | Physician and practitioner services (fee schedule) | $251.98 | $134.21 | 1 of 19 |
| 11044 | Physician and practitioner services (fee schedule) | $337.92 | $182.12 | 1 of 19 |
| 11055 | Physician and practitioner services (fee schedule) | $17.73 | $14.80 | 6 of 19 |
| 11056 | Physician and practitioner services (fee schedule) | $28.57 | $20.38 | 6 of 19 |
| 11057 | Physician and practitioner services (fee schedule) | $39.74 | $26.13 | 4 of 19 |
| 11102 | Physician and practitioner services (fee schedule) | $71.13 | $32.23 | 4 of 19 |
| 11103 | Physician and practitioner services (fee schedule) | $35.56 | $18.65 | 4 of 19 |
| 11104 | Physician and practitioner services (fee schedule) | $77.06 | $40.43 | 5 of 19 |
| 11105 | Physician and practitioner services (fee schedule) | $41.49 | $22.05 | 4 of 19 |
| 11106 | Physician and practitioner services (fee schedule) | $88.92 | $49.21 | 5 of 19 |
Managed care in Nebraska
5 plans on record, 9 state-directed payment records, 911 published capitation cells.
Who sets the rate, line by line →Recent rate changes and notices
Frequently asked questions
Where does Nebraska publish its Medicaid fee schedules?
Nebraska publishes rates across 56 official documents (fee schedules, rate notices and bulletins). Every rate on this page links to its source document.
How many Medicaid rates does Nebraska publish?
40,192 rates are current across 111 services and 10 programs, with 280,474 versions on record since 2021-01-01.
Do Nebraska Medicaid managed-care plans pay the fee schedule?
For 9 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 Nebraska rate cardYour codes, what Nebraska pays, what plans must pay, and every change in 2026.