Peer support (behavioral health): Medicaid rates by state

A billing code alone doesn't make a fair comparison: states bill peer support (behavioral health) under different codes, units and provider types. This benchmark lines up one comparable rate per state.

• Provider level. States are compared at the physician or licensed psychologist (incl. BCBA-D) level. Rates for other levels on file (any qualified provider, licensed mental health clinician, registered nurse and occupational therapist) are kept separate, never mixed into this ranking.
• Unit. All 19 states publish their headline rate per 15 min, so the amounts compare directly. 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. 15 of the 19 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. 13,359 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, California, pays $1,526.52 per hour; the lowest, Ohio, pays $8.76 per hour, a 174.3x gap. 8 of the 19 states pay above the median of $40.00 per hour. Common reasons rates for behavioral health services spread this way:

• Behavioral health is frequently run through a separate state agency, a carve-out or a specialty plan, with its own rate-setting cycle.
• Many states pay behavioral health services differently by the practitioner's credential, from psychiatrist and psychologist to licensed clinical social worker, counselor and peer specialist.
• 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.

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.