School-based Medicaid service (billed by a school district): Medicaid rates by state

This is a service-level benchmark rather than a single code: each state's headline rate for school-based Medicaid service (billed by a school district) is chosen to match the same service and the same provider level.

• Provider level. States are compared at the agency provider level. Rates for other levels on file (any qualified provider, registered nurse, licensed practical / vocational nurse and bachelor's-level staff) are kept separate, never mixed into this ranking.
• Unit. Of the 5 states, 4 publish their headline rate per 15 min and 1 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. 4 of the 5 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. 535 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, Rhode Island, pays $149.00 per hour; the lowest, Oklahoma, pays $14.44 per hour, a 10.3x gap. 2 of the 5 states pay above the median of $64.48 per hour. Common reasons rates for other services spread this way:

• Rate studies, settlements and targeted increases for workforce shortages move individual services out of step with the rest of a state's schedule.
• Each state sets its own fee schedule and updates it on its own budget cycle, so two states can price the same service from different base years.
• States pay different amounts by provider type, setting and program, and the published rate may already include or exclude add-ons that another state pays separately.

Billing notes

This service is billed in the unit the state's schedule defines.