97112 Medicaid reimbursement rates by state
Balance and coordination retraining. 45 state Medicaid programs publish a fee-for-service rate for 97112 at the therapist pt level. Rates run from $9.91 in Rhode Island to $49.66 in Alaska, with a median of $25.83.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 45
- Median rate
- $25.83units vary by state
- Highest
- $49.66Alaska
- Medicare (non-facility)
- $30.46–$41.952026 physician fee schedule
97112 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 |
|---|---|---|---|---|---|---|
| AlaskaPhysical therapist · Alaska Medicaid (fee-for-service, Department of Health) | $49.66since 2026-07-01 | 15 min | $198.64 | Not classified | 118% | Alaska Medicaid School-Based Services Fe |
| New MexicoPhysical therapist · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $47.43since 2025-01-01 | 15 min | $189.72 | Plans must pay at least this | 151% | New Mexico Medicaid Fee for Service CPT |
| MontanaPhysical therapist · Montana Medicaid and HMK Plus (fee-for-service) | $41.40since 2026-07-01 | 15 min | $165.60 | Not classified | 126% | Montana Healthcare Programs fee schedule |
| HawaiiPhysical therapist · Hawaii Medicaid (Med-QUEST) fee-for-service | $34.19since 2026-06-01 | 15 min | $136.76 | Plans negotiate; applies out of network | 98% | Medicaid Fee-For-Service (FFS) Fee Sched |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $33.75since 2017-09-01 | 15 min | $135.00 | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| South DakotaPhysical therapist · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $31.37since 2026-07-01 | 15 min | $125.48 | Not classified | 96% | South Dakota Medicaid Physician fee sche |
| IndianaPhysical therapist · Indiana Medicaid (fee-for-service) | $30.65since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $30.59since 2026-10-01 | 15 min | $122.36 | Plans negotiate; applies out of network | 95% | AHCCCS Arizona Health Care Cost Containm |
| UtahPhysical therapist · Utah Medicaid (fee-for-service, Traditional plan) | $30.09since 2026-07-01 | 15 min | $120.36 | Plans negotiate; applies out of network | 95% | Utah Medicaid Coverage and Reimbursement |
| NevadaPhysical therapist · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $29.37since 2025-01-01 | 15 min | $117.48 | Plans must pay at least this | 90% | Provider Type 34, Therapy Reimbursement |
| MissouriPhysical therapist · Missouri MO HealthNet (fee-for-service) | $29.30since 2022-07-01 | 15 min | $117.20 | Paid by the state, outside plans | — | MO HealthNet fee schedule: First Steps |
| DelawarePhysical therapist · Delaware Medicaid (fee-for-service, DMMA / DMAP) | $29.15since 2025-01-01 | 15 min | $116.60 | Not classified | 89% | DMAP 2025 Physician Fee Schedule |
| OklahomaPhysical therapist · Oklahoma SoonerCare (fee-for-service, OHCA) | $29.01since 2026-07-01 | 15 min | $116.04 | Plans must pay at least this | 94% | SoonerCare Title XIX Fee Schedule |
| WyomingPhysical therapist · Wyoming Medicaid (fee-for-service, Department of Health) | $28.75since 2026-07-01 | 15 min | $115.00 | Not classified | 88% | Wyoming Medicaid Downloadable Fee Schedu |
| MarylandPhysical therapist · Maryland Medicaid (fee-for-service, MDH) | $27.85since 2026-01-01 | 15 min | $111.40 | Not classified | 81–84% | Maryland Medicaid Professional Services |
| VermontPhysical therapist · Vermont Medicaid (fee-for-service, DVHA) | $27.58since 2026-01-01 | 15 min | $110.32 | Not classified | 85% | Vermont Medicaid Fee Schedule - CPT Code |
| ColoradoPhysical therapist · Child Health Plan Plus (CHP+, Colorado's CHIP) | $27.42since 2026-07-01 | 15 min | $109.68 | Plans negotiate; applies out of network | 81% | Child Health Plan Plus FY 2026-2027 Fee |
| NebraskaPhysical therapist · Nebraska Medicaid (fee-for-service) | $27.42since 2026-07-01 | 15 min | $109.68 | Plans negotiate; applies out of network | 88% | Nebraska Medicaid fee schedule 471-000-5 |
| MississippiPhysical therapist · Mississippi Medicaid (fee-for-service) | $27.41since 2026-07-01 | 15 min | $109.64 | Plans must pay at least this | 90% | DOM Comprehensive Fee Schedule, Septembe |
| IdahoPhysical therapist · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $27.04since 2026-07-01 | 15 min | $108.16 | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| LouisianaPhysical therapist · Louisiana Medicaid (fee-for-service) | $26.77since 2022-07-01 | 15 min | $107.08 | Paid by the state, outside plans | 84–87% | Louisiana Medicaid EPSDT Early Intervent |
| OregonPhysical therapist · Oregon Health Plan (fee-for-service, OHA) | $26.47since 2026-02-01 | 15 min | $105.88 | Plans negotiate; applies out of network | 76–81% | OHP FFS medical-dental fee schedule (fee |
| MassachusettsPhysical therapist · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $25.83since 2026-10-01 | 15 min | $103.32 | Plans negotiate; applies out of network | 71–77% | Emergency Adoption (date filed: Septembe |
| KansasPhysical therapist · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $25.78since 2024-08-01 | 15 min | $103.12 | Paid by the state, outside plans | 83% | KMAP Fee Schedule MKN Medicaid (FeeSched |
| New HampshirePhysical therapist · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $25.45since 2023-07-01 | 15 min | $101.80 | Plans negotiate; applies out of network | 76% | 2026 Fee Schedule - Covered Procedures R |
| MinnesotaPhysical therapist · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $25.21since 2026-02-01 | 15 min | $100.84 | Plans negotiate; applies out of network | 77% | MHCP Fee Schedule - Current Fee Schedule |
| ConnecticutPhysical therapist · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $23.55since 2026-01-01 | 15 min | $94.20 | Not classified | 69% | CMAP fee schedule: Independent Physical |
| North CarolinaPhysical therapist · North Carolina Medicaid Direct (fee-for-service) | $23.55since 2025-10-01 | 15 min | $94.20 | Plans negotiate; applies out of network | 75% | NC Medicaid fee schedule 'Occupational T |
| MainePhysical therapist · MaineCare (fee-for-service) | $22.70since 2026-01-01 | 15 min | $90.80 | Not classified | 70–72% | MaineCare Fee Schedule (MaineCare UCR, H |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $22.65since 2020-05-01 | 15 min | $90.60 | Plans must pay at least this | 73% | Iowa Medicaid fee schedule #02 PHYSICIAN |
| South CarolinaPhysical therapist · South Carolina Healthy Connections Medicaid (fee-for-service) | $22.28since 2011-07-11 | 15 min | $89.12 | Not classified | 71% | SCDHHS Base Physician Fee Schedule (sche |
| West VirginiaPhysical therapist · West Virginia Medicaid School-Based Health Services (SBHS) | $22.20since 2026-04-01 | 15 min | $88.80 | Paid by the state, outside plans | — | School Based Health Services (SBHS) - Di |
| IllinoisPhysical therapist · Illinois Medicaid (HFS fee-for-service) | $21.63since 2024-04-01 | 15 min | $86.52 | Plans negotiate; applies out of network | 65–69% | HFS Practitioner Fee Schedule (effective |
| GeorgiaPhysical therapist · Georgia Medicaid (fee-for-service) | $21.03since 2023-04-01 | 15 min | $84.12 | Plans negotiate; applies out of network | 64–68% | Max Allow Payment_OutP Site of Service A |
| MichiganPhysical therapist · Michigan Medicaid (fee-for-service) | $20.87since 2026-01-01 | 15 min | $83.48 | Plans negotiate; applies out of network | 64–66% | MDHHS Occupational Therapy Fee Schedule |
| FloridaPhysical therapist · Florida Medicaid (fee-for-service) | $20.33since 2026-01-01 | 15 min | $81.32 | Plans negotiate; applies out of network | 60–63% | Physical Therapy Fee Schedule (Physical |
| WisconsinPhysical therapist · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $20.29since 2022-01-01 | 15 min | $81.16 | Plans negotiate; applies out of network | 64% | ForwardHealth max fee schedule: Therapy- |
| WashingtonPhysical therapist · Washington Apple Health (Medicaid) fee-for-service | $19.87since 2026-07-01 | 15 min | $79.48 | Plans negotiate; applies out of network | 54–59% | HCA Habilitative services fee schedule ( |
| OhioPhysical therapist · Ohio Medicaid School Program (school-based services) | $18.50since 2020-06-12 | 15 min | $74.00 | Paid by the state, outside plans | 59% | Appendix DD to OAC 5160-1-60 (Non-Instit |
| VirginiaPhysical therapist · Virginia Medicaid (fee-for-service, DMAS) | $18.31since 2019-12-01 | 15 min | $73.24 | Plans negotiate; applies out of network | 57% | DMAS procedure fee file cptmedical4.csv |
| PennsylvaniaPhysical therapist · Pennsylvania Medical Assistance (fee-for-service) | $16.75since 2021-09-01 | 15 min | $67.00 | Plans negotiate; applies out of network | 50–53% | PA DHS PROMISe Outpatient Fee Schedule ( |
| New JerseyPhysical therapist · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $16.57since 2026-07-01 | 15 min | $66.28 | Not classified | 46–48% | NJMMIS Procedure Master Listing CPTHCPCS |
| CaliforniaPhysical therapist · California Medi-Cal (fee-for-service) | $12.22since 2026-10-01 | 15 min | $48.88 | Plans negotiate; applies out of network | 30–36% | Medi-Cal Rates (Rates files zip: rates_d |
| KentuckyPhysical therapist · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $11.61since 2026-01-01 | 15 min | $46.44 | Plans negotiate; applies out of network | 37% | KY Medicaid OT fee schedule (2026Occupat |
| Rhode IslandPhysical therapist · Rhode Island Medicaid (fee-for-service) | $9.91since 1996-01-01 | 15 min | $39.64 | Plans negotiate; applies out of network | 30% | RI Medicaid Interactive Fee For Service |
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 97112?
It depends on the state. Of the 45 states with a published fee-for-service rate, the median is $25.83. Alaska pays the most ($49.66 per 15 min) and Rhode Island the least ($9.91 per 15 min).
Which state pays the highest Medicaid rate for 97112?
Alaska, at $49.66 per 15 min ($198.64 per hour), effective 2026-07-01.
How do Medicaid rates for 97112 compare with Medicare?
Where the billing units match, Medicaid pays between 30% and 151% of the 2026 Medicare physician fee schedule amount for the state (non-facility).
Do managed-care plans pay the same rate for 97112?
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.
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Track 97112 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.