Rhode Island Medicaid reimbursement rates
76,101 current fee-for-service and managed-care rates from Rhode Island Medicaid, across 91 services and 26 programs, normalized by code, provider level and unit. Each links to one of 187 official source documents.
Last retrieved 2026-10-05. History back to 1993-01-01.
- Current rates
- 76,101
- Services
- 91
- Programs
- 26
- Lines with a plan rule
- 14of 22 service lines
By industry
Applied behavior analysis (ABA)Rhode Island rates, labor costs and changesBehavioral healthRhode Island rates, labor costs and changesHome healthRhode Island rates, labor costs and changesHome care & personal careRhode Island rates, labor costs and changesPrivate duty nursingRhode Island rates, labor costs and changesSkilled nursing facilitiesRhode Island rates, labor costs and changesHospiceRhode Island rates, labor costs and changesIntellectual & developmental disabilitiesRhode Island rates, labor costs and changesOutpatient therapy (PT, OT, speech)Rhode Island rates, labor costs and changes
Rhode Island 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 | $26.95 | 15 min | $107.80 | 31 |
| ABA assessment support by a technician | ABA / autism services | $45.34 | 15 min | $181.36 | 1 |
| ABA parent and caregiver training | ABA / autism services | $54.97 | 15 min | $219.88 | 30 |
| ABA therapy with plan changes by an analyst | ABA / autism services | $45.34 | 15 min | $181.36 | 1 |
| Group ABA parent training (several families) | ABA / autism services | $45.34 | 15 min | $181.36 | 1 |
| Group ABA therapy led by a technician | ABA / autism services | $45.34 | 15 min | $181.36 | 1 |
| Group ABA therapy led by an analyst | ABA / autism services | $45.34 | 15 min | $181.36 | 1 |
| One-on-one ABA therapy by a technician | ABA / autism services | $45.34 | 15 min | $181.36 | 1 |
| Behavioral health services (fee schedule) | Behavioral health | $0.01 | — | $0.04 | 295 |
| Certified community behavioral health clinic (CCBHC) rate | Behavioral health | $1,038.00 | — | — | 35 |
| Community-based wraparound services | Behavioral health | $22.40 | — | $89.60 | 5 |
| Mental health assessment (non-physician) | Behavioral health | $143.13 | — | — | 14 |
| Mental health counseling | Behavioral health | $30.75 | — | — | 31 |
| Mental health service plan development | Behavioral health | $22.98 | — | $83.08 | 30 |
| Outpatient psychotherapy and diagnostic evaluation | Behavioral health | $0.01 | — | $0.02 | 894 |
| Skills training and development | Behavioral health | $12.37 | 15 min | $49.48 | 17 |
| FQHC / RHC visit (PPS or APM rate) | Clinics (FQHC/RHC) | $285.81 | — | — | 27 |
| Dental services | Dental | $201.03 | — | — | 327 |
| Durable medical equipment | Equipment & supplies | $102.03 | — | $54.24 | 1614 |
| Enteral and parenteral nutrition | Equipment & supplies | $33.62 | day | — | 29 |
| Medical supplies | Equipment & supplies | $9.06 | — | — | 514 |
| Orthotics and prosthetics | Equipment & supplies | $356.65 | — | $73.34 | 858 |
| Adult day services | Other home & community services | $61.93 | day | — | 37 |
| Assisted living / alternative living services | Other home & community services | $94.00 | day | — | 2 |
| Case management / support coordination | Other home & community services | $93.51 | — | $95.60 | 122 |
| Emergency response system installation | Other home & community services | $50.00 | — | — | 6 |
| Emergency response system monitoring | Other home & community services | $35.00 | month | — | 6 |
| Financial management services (self-direction) | Other home & community services | $57.52 | day | — | 12 |
| HCBS waiver service (other) | Other home & community services | $26.77 | 15 min | $86.48 | 125 |
| Home-delivered meals | Other home & community services | $13.60 | meal | — | 24 |
| Interpreter services | Other home & community services | $18.51 | 15 min | $74.04 | 38 |
| Nursing assessment | Other home & community services | $201.12 | — | — | 6 |
| Respite care (daily) | Other home & community services | $449.29 | day | — | 4 |
| Respite care (hourly) | Other home & community services | $7.05 | 15 min | $28.20 | 51 |
| Respite in a facility (daily) | Other home & community services | $70.00 | day | — | 2 |
| Self-direction coaching / supports broker | Other home & community services | $8.85 | 15 min | $35.40 | 4 |
| Service planning meeting | Other home & community services | $256.92 | — | — | 3 |
| Social work services (waiver) | Other home & community services | $4.95 | 15 min | $19.80 | 1 |
| Home health aide visit | Home health | $10.70 | 15 min | $42.80 | 2 |
| Home health nurse visit (RN or LPN) | Home health | $97.72 | 15 min | $73.44 | 2 |
| Home health occupational therapy | Home health | $41.20 | 15 min | $177.08 | 2 |
| Home health physical therapy | Home health | $41.20 | 15 min | $177.08 | 2 |
| Home health speech therapy | Home health | $41.20 | 15 min | $177.08 | 2 |
| Home health visit (other or unspecified) | Home health | $0.405 | 15 min | $1.56 | 10 |
| Hospice routine home care (daily) | Hospice | $252.76 | day | — | 2 |
| Inpatient DRG pricing input (outlier, cost ratio, stay) | Hospital inpatient | $0.47 | — | — | 17 |
| Inpatient DRG relative weight | Hospital inpatient | $1.35 | — | — | 1272 |
| Inpatient hospital stay (DRG base rate) | Hospital inpatient | $1.63 | — | — | 10 |
| Outpatient hospital payment method | Hospital outpatient | $150.00 | — | — | 1 |
| Outpatient hospital services (fee schedule) | Hospital outpatient | $96.18 | — | $68.14 | 522 |
| Surgery center payment group rate | Hospital outpatient | $390.00 | — | — | 18 |
| Day habilitation / day program (IDD) | IDD services | $6.86 | day | $27.44 | 43 |
| ICF/IID stay (daily rate) | IDD services | $734.52 | — | — | 1 |
| In-home and community living supports (IDD) | IDD services | $12.75 | — | $49.44 | 78 |
| Prevocational services | IDD services | $230.81 | hour | $230.81 | 27 |
| Residential habilitation / group home supports | IDD services | $260.03 | day | — | 66 |
| Supported employment (job coaching) | IDD services | $8.53 | 15 min | $34.12 | 52 |
| Supported employment follow-along | IDD services | $13.68 | 15 min | $54.72 | 8 |
| Transitional / crisis stabilization living supports | IDD services | $52.33 | 15 min | $209.32 | 3 |
| Clinical lab tests | Lab & pathology | $22.09 | — | — | 7227 |
| Nursing facility case-mix (PDPM nursing component) weight | Nursing facility | $1.48 | — | — | 26 |
| Nursing home stay (daily rate) | Nursing facility | $370.61 | — | — | 2931 |
| Directed payment uniform increase (required MCO uplift) | Other | $2.60 | month | — | 7 |
| Early intervention services for infants and toddlers | Other | $54.97 | — | — | 42 |
| Managed care capitation rate | Other | $879.54 | month | — | 176 |
| School-based Medicaid service (billed by a school district) | Other | $37.25 | 15 min | $149.00 | 9 |
| Companion care | Personal care & attendant | $43.45 | 15 min | $7.08 | 9 |
| Homemaker / housekeeping help | Personal care & attendant | $10.46 | 15 min | $43.88 | 177 |
| Personal care / attendant care (hourly) | Personal care & attendant | $10.79 | 15 min | $45.32 | 360 |
| Physician-administered drugs (J-codes) | Pharmacy | $19.65 | — | — | 1802 |
| Private duty nursing (hourly shifts) | Private duty nursing | $17.33 | 15 min | $69.32 | 23 |
| Waiver nursing (RN or LPN, by the 15 minutes) | Private duty nursing | $22.96 | 15 min | $91.84 | 102 |
| Physician and practitioner services (fee schedule) | Physician & professional | $100.80 | — | $56.13 | 49582 |
| Imaging and radiology | Radiology | $87.19 | — | — | 5758 |
| Nutrition counseling (dietitian) | Therapy (PT/OT/speech) | $9.91 | 15 min | $39.64 | 4 |
| Occupational therapy | Therapy (PT/OT/speech) | $31.51 | 15 min | $126.04 | 65 |
| Occupational therapy evaluation | Therapy (PT/OT/speech) | $112.30 | — | — | 24 |
| Orthotic and prosthetic fitting and training | Therapy (PT/OT/speech) | $16.92 | 15 min | $67.68 | 5 |
| Physical therapy | Therapy (PT/OT/speech) | $31.51 | 15 min | $126.04 | 63 |
| Physical therapy evaluation | Therapy (PT/OT/speech) | $105.04 | — | — | 26 |
| Speech-generating device evaluation | Therapy (PT/OT/speech) | $61.30 | — | — | 3 |
| Speech-generating device therapy | Therapy (PT/OT/speech) | $33.23 | — | — | 3 |
| Speech-language evaluation | Therapy (PT/OT/speech) | $119.55 | — | — | 26 |
| Speech-language therapy | Therapy (PT/OT/speech) | $31.51 | — | $113.92 | 57 |
| Swallowing and feeding evaluation | Therapy (PT/OT/speech) | $23.74 | — | — | 3 |
| Swallowing and feeding therapy | Therapy (PT/OT/speech) | $21.47 | — | — | 4 |
| Ambulance mileage | Transportation | $0.56 | mile | — | 10 |
| Ground ambulance transport | Transportation | $69.95 | — | — | 79 |
| Non-emergency medical transportation (NEMT) | Transportation | $23.46 | — | — | 27 |
| Eyeglasses and contact lenses | Vision & hearing | $54.91 | — | — | 103 |
| Hearing aids and hearing services | Vision & hearing | $575.00 | — | — | 28 |
Most-compared billing codes in Rhode Island
Where Rhode Island ranks among states for codes published widely. Rank 1 = highest rate.
| Code | Service | Rhode Island | All-state median | Rank |
|---|---|---|---|---|
| 10005 | Physician and practitioner services (fee schedule) | $14.82 | $88.19 | 50 of 50 |
| 10006 | Physician and practitioner services (fee schedule) | $7.06 | $46.23 | 50 of 50 |
| 10007 | Physician and practitioner services (fee schedule) | $33.40 | $203.95 | 50 of 50 |
| 10008 | Physician and practitioner services (fee schedule) | $18.82 | $95.09 | 49 of 50 |
| 10009 | Physician and practitioner services (fee schedule) | $54.65 | $276.55 | 49 of 50 |
| 10010 | Physician and practitioner services (fee schedule) | $32.94 | $157.44 | 50 of 50 |
| 10021 | Physician and practitioner services (fee schedule) | $9.87 | $73.91 | 50 of 50 |
| 10030 | Physician and practitioner services (fee schedule) | $113.88 | $401.12 | 41 of 50 |
| 10060 | Physician and practitioner services (fee schedule) | $6.30 | $88.74 | 50 of 50 |
| 10061 | Physician and practitioner services (fee schedule) | $7.20 | $153.30 | 50 of 50 |
| 10080 | Physician and practitioner services (fee schedule) | $9.21 | $129.47 | 50 of 50 |
| 10081 | Physician and practitioner services (fee schedule) | $10.08 | $200.51 | 49 of 50 |
| 10120 | Physician and practitioner services (fee schedule) | $6.30 | $98.41 | 50 of 50 |
| 10121 | Physician and practitioner services (fee schedule) | $8.10 | $171.22 | 50 of 50 |
| 10140 | Physician and practitioner services (fee schedule) | $5.04 | $109.79 | 50 of 50 |
| 10160 | Physician and practitioner services (fee schedule) | $6.30 | $86.10 | 50 of 50 |
| 10180 | Physician and practitioner services (fee schedule) | $5.04 | $182.52 | 50 of 50 |
| 11000 | Physician and practitioner services (fee schedule) | $5.04 | $38.05 | 50 of 50 |
| 11001 | Physician and practitioner services (fee schedule) | $3.36 | $18.34 | 50 of 50 |
| 11004 | Physician and practitioner services (fee schedule) | $61.42 | $437.24 | 49 of 50 |
| 11005 | Physician and practitioner services (fee schedule) | $83.67 | $594.32 | 49 of 50 |
| 11006 | Physician and practitioner services (fee schedule) | $78.18 | $545.22 | 49 of 50 |
| 11008 | Physician and practitioner services (fee schedule) | $31.50 | $211.94 | 50 of 50 |
| 11010 | Physician and practitioner services (fee schedule) | $27.12 | $286.71 | 49 of 50 |
| 11011 | Physician and practitioner services (fee schedule) | $32.32 | $326.17 | 49 of 50 |
| 11012 | Physician and practitioner services (fee schedule) | $44.92 | $442.71 | 49 of 50 |
| 11042 | Physician and practitioner services (fee schedule) | $5.04 | $84.55 | 50 of 50 |
| 11043 | Physician and practitioner services (fee schedule) | $6.30 | $167.89 | 50 of 50 |
| 11044 | Physician and practitioner services (fee schedule) | $7.50 | $227.02 | 50 of 50 |
| 11055 | Physician and practitioner services (fee schedule) | $2.57 | $40.24 | 50 of 50 |
| 11056 | Physician and practitioner services (fee schedule) | $3.87 | $47.35 | 50 of 50 |
| 11057 | Physician and practitioner services (fee schedule) | $4.15 | $52.53 | 50 of 50 |
| 11102 | Physician and practitioner services (fee schedule) | $11.56 | $71.28 | 50 of 50 |
| 11103 | Physician and practitioner services (fee schedule) | $6.23 | $36.83 | 50 of 50 |
| 11104 | Physician and practitioner services (fee schedule) | $14.53 | $84.93 | 50 of 50 |
| 11105 | Physician and practitioner services (fee schedule) | $7.14 | $42.80 | 50 of 50 |
| 11106 | Physician and practitioner services (fee schedule) | $17.59 | $101.36 | 50 of 50 |
| 11107 | Physician and practitioner services (fee schedule) | $8.42 | $50.82 | 50 of 50 |
| 11300 | Physician and practitioner services (fee schedule) | $4.62 | $55.51 | 50 of 50 |
| 11301 | Physician and practitioner services (fee schedule) | $5.04 | $67.43 | 50 of 50 |
Managed care in Rhode Island
12 plans on record, 11 state-directed payment records, 1,603 published capitation cells.
Who sets the rate, line by line →Recent rate changes and notices
Frequently asked questions
Where does Rhode Island publish its Medicaid fee schedules?
Rhode Island publishes rates across 187 official documents (fee schedules, rate notices and bulletins). Every rate on this page links to its source document.
How many Medicaid rates does Rhode Island publish?
76,101 rates are current across 91 services and 26 programs, with 137,316 versions on record since 1993-01-01.
Do Rhode Island Medicaid managed-care plans pay the fee schedule?
For 14 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.
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Your Rhode Island rate cardYour codes, what Rhode Island pays, what plans must pay, and every change in 2026.