421 Medicaid reimbursement rates by state
Home health physical therapy. 6 state Medicaid programs publish a fee-for-service rate for 421 at the therapist pt level. Rates run from $84.14 in Connecticut to $191.77 in Oregon, with a median of $127.22.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 6
- Median rate
- $127.22units vary by state
- Highest
- $191.77Oregon
- Medicare (non-facility)
- —not on the physician fee schedule
421 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 |
|---|---|---|---|---|---|---|
| OregonPhysical therapist · Oregon Health Plan (fee-for-service, OHA) | $191.77since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | OHA Fee-for-service home health rates ef |
| IowaPhysical therapist · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $146.92since 2025-07-01 | — | — | Plans must pay at least this | — | Iowa HHA LUPA Rates Effective July 1, 20 |
| ColoradoPhysical therapist · Health First Colorado (Colorado Medicaid, fee-for-service) | $136.14since 2022-07-01 | One visit up to 2 ½ hours | — | Paid by the state, outside plans | — | Home Health (07/22) |
| IdahoPhysical therapist · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $118.29since 2025-09-01 | visit | — | Not classified | — | Home Health Fee Schedule - SFY 2026 (arc |
| MontanaAgency provider · Montana Medicaid and HMK Plus (fee-for-service) | $88.01since 2025-07-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $84.14since 2021-07-01 | visit | — | Not classified | — | CMAP fee schedule: Home Health Services |
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 421?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $127.22. Oregon pays the most ($191.77) and Connecticut the least ($84.14 per visit).
Which state pays the highest Medicaid rate for 421?
Oregon, at $191.77, effective 2025-01-01.
Do managed-care plans pay the same rate for 421?
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.