Physical therapy: Medicaid rates by state

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

• Provider level. States are compared at the physical therapist level. Rates for other levels on file (therapy assistant, physician or licensed psychologist, occupational therapist and speech-language pathologist) are kept separate, never mixed into this ranking.
• Unit. All 48 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. 48 of the 48 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. 4,173 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, Alaska, pays $176.68 per hour; the lowest, Maine, pays $46.64 per hour, a 3.8x gap. 24 of the 48 states pay above the median of $95.00 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

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. Many treatment codes are timed in 15-minute units, while evaluations and re-evaluations are billed once per session.