Other therapy services: Medicaid rates by state

States publish other therapy services under their own codes, modifiers and units. To compare them, this page picks the rate in each state that matches the same service and provider level.

• Provider level. States are compared at the respiratory therapist level. Rates for other levels on file (any qualified provider, physician or licensed psychologist, clinical nurse specialist and physical therapist) are kept separate, never mixed into this ranking.
• Unit. Of the 7 states, 6 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. 6 of the 7 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. 15,376 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 $104.20 per hour; the lowest, North Carolina, pays $37.40 per hour, a 2.8x gap. 3 of the 7 states pay above the median of $60.00 per hour. Common reasons rates for therapy (PT/OT/speech) services spread this way:

• States pay therapy by CPT code, but many pay therapy assistants a reduced percentage and some pay differently in outpatient hospital, private practice and home settings.
• Children's therapy is driven by the EPSDT benefit, so some states maintain separate pediatric rates or programs.
• Visit limits, prior authorization and annual caps vary by state and change how much a single code is worth to a practice.

Billing notes

Many treatment codes are timed in 15-minute units, while evaluations and re-evaluations are billed once per session. Medicare applies a rule for counting timed minutes into units; Medicaid programs may follow it or set their own, so check the state's therapy manual.