Mental health counseling: Medicaid rates by state

This is a service-level benchmark rather than a single code: each state's headline rate for mental health counseling is chosen to match the same service and the same provider level.

• Provider level. States are compared at the assistant behavior analyst (BCaBA / LaBA) level. Rates for other levels on file (any qualified provider, licensed mental health clinician, behavior analyst and physician or licensed psychologist) are kept separate, never mixed into this ranking.
• Unit. Of the 14 states, 10 publish their headline rate per 15 min, 2 per 30 min and 2 per hour. The ranking converts every time-based rate to an hour of service, so states that bill by the 15 minutes and by the hour compare directly.
• Variants. 11 of the 14 states publish more than one rate for this service (by modifier, program, setting or provider type); the headline rate is the one that matches the comparison, and the workspace lists every variant.
• Depth. 14,116 rates for this service are on file across all states, versions and provider levels; this page shows one headline rate per state.

The highest-paying state, Arizona, pays $113.92 per hour; the lowest, Nevada, pays $25.56 per hour, a 4.5x gap. 7 of the 14 states pay above the median of $58.18 per hour. Common reasons rates for behavioral health services spread this way:

• Community mental health and substance use services are often billed under H and T codes that each state defines for itself, so the same code can describe a different service in two states.
• States add enhanced rates for crisis services, certified community behavioral health clinics and integrated care that sit outside the base schedule.
• Behavioral health is frequently run through a separate state agency, a carve-out or a specialty plan, with its own rate-setting cycle.

Billing notes

Modifiers such as HO (master's level), HN (bachelor's level) and HP (doctoral level) identify the practitioner, and many states publish a different rate for each. Psychotherapy codes are defined by session length, so one unit is one session of the stated duration; H codes are billed in whatever unit the state defines, often 15 minutes, an hour or a day.