97010 Medicaid reimbursement rates by state
Occupational therapy. 14 state Medicaid programs publish a fee-for-service rate for 97010 at the physician psychologist level. Rates run from $3.68 in North Carolina to $23.00 in Louisiana, with a median of $6.01.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 14
- Median rate
- $6.01units vary by state
- Highest
- $23.00Louisiana
- Medicare (non-facility)
- —not on the physician fee schedule
97010 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 |
|---|---|---|---|---|---|---|
| LouisianaOccupational therapist · Louisiana Residential Options Waiver (ROW, OCDD/OIDD 1915(c) waiver) | $23.00since 2025-11-18 | 15 min | $92.00 | Paid by the state, outside plans | — | Residential Options Waiver rate and proc |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $16.75since 1989-01-02 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $9.84since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $9.66since 2024-04-01 | — | — | Plans negotiate; applies out of network | — | Max Allow Payment_OutP Site of Service A |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $9.43since 2013-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $8.77since 2022-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid PT fee schedule (2022 PT Fee |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $6.22since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $5.79since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file cptmedical4.csv |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $5.45since 2026-01-01 | — | — | Not classified | — | CMAP fee schedule: Independent Physical |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $5.20since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $4.88since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Emergency Adoption (date filed: Septembe |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $4.88since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $4.28since 2013-01-01 | — | — | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $3.68since 2025-10-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Nurse Practiti |
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 97010?
It depends on the state. Of the 14 states with a published fee-for-service rate, the median is $6.01. Louisiana pays the most ($23.00 per 15 min) and North Carolina the least ($3.68).
Which state pays the highest Medicaid rate for 97010?
Louisiana, at $23.00 per 15 min ($92.00 per hour), effective 2025-11-18.
Do managed-care plans pay the same rate for 97010?
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.