0551 Medicaid reimbursement rates by state
Home health nurse visit (RN or LPN). 5 state Medicaid programs publish a fee-for-service rate for 0551 at the agency level. Rates run from $84.50 in Wyoming to $181.02 in Virginia, with a median of $155.39.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 5
- Median rate
- $155.39units vary by state
- Highest
- $181.02Virginia
- Medicare (non-facility)
- —not on the physician fee schedule
0551 rate in every state
One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| VirginiaAgency provider · Virginia Medicaid (fee-for-service, DMAS) | $181.02since 2025-07-01 | visit | — | Plans negotiate; applies out of network | — | SFY 26 Rates Web File |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $174.54since 2026-01-01 | — | — | Not classified | — | PT 57-26 FY26 Rates for Home Health Serv |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $155.39since 2024-09-06 | visit | — | Plans negotiate; applies out of network | — | Episodic Payment System - Statewide Weig |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $125.34since 2026-04-01 | — | — | Plans negotiate; applies out of network | — | Home Health Agencies, effective 4/1/2026 |
| WyomingAny qualified provider (rate does not vary by provider) · Wyoming Title 25 (involuntary hospitalization) state benefit plan | $84.50since 2019-01-01 | — | — | Not classified | — | Wyoming Medicaid Downloadable Fee Schedu |
Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.
Frequently asked questions
What does Medicaid pay for 0551?
It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $155.39. Virginia pays the most ($181.02 per visit) and Wyoming the least ($84.50).
Which state pays the highest Medicaid rate for 0551?
Virginia, at $181.02 per visit, effective 2025-07-01.
Do managed-care plans pay the same rate for 0551?
Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The table shows the rule for each state, cited to the contract or statute.