97124 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 25 state Medicaid programs publish a fee-for-service rate for 97124 at the therapy assistant level. Rates run from $10.29 in California to $30.15 in Nebraska, with a median of $20.56.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 25
- Median rate
- $20.56units vary by state
- Highest
- $30.15Nebraska
- Medicare (non-facility)
- $27.28–$38.682026 physician fee schedule
97124 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 |
|---|---|---|---|---|---|---|
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $30.15since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $28.24since 2025-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $28.18since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $25.90since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Part II Policies and Procedures for Chil |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $25.75since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file cptmedical4.csv |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $24.07since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $23.89since 2025-07-01 | — | — | Plans must pay at least this | — | Louisiana Medicaid Professional Services |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $23.23since 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) | $22.89since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $22.53since 2019-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $22.49since 2022-07-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Podiatry |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $22.00since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| ColoradoAny qualified provider (rate does not vary by provider) · Colorado HCBS waiver for children with complex health needs (CwCHN) | $20.56since 2026-07-01 | 15 min | $82.24 | Paid by the state, outside plans | — | CwCHN, CHRP (effective July 1, 2026) |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $19.30since 2024-04-01 | — | — | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $18.96since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Occupational Therapy Fee Schedule |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $18.61since 2025-10-01 | — | — | Paid by the state, outside plans | — | NC Medicaid fee schedule 'Children Devel |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $18.15since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Habilitative services fee schedule ( |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $18.12since 2026-01-01 | — | — | Not classified | — | CMAP fee schedule: Independent Physical |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $17.65since 2024-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #38 CERTIFIED |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $17.13since 2022-01-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Therapy- |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $16.75since 1999-08-03 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $15.14since 2026-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $14.95since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | Appendix DD to OAC 5160-1-60 (Non-Instit |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $10.40since 2026-01-01 | 15 min | $41.60 | Plans negotiate; applies out of network | — | KY Medicaid OT fee schedule (2026Occupat |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $10.29since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
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 97124?
It depends on the state. Of the 25 states with a published fee-for-service rate, the median is $20.56. Nebraska pays the most ($30.15) and California the least ($10.29).
Which state pays the highest Medicaid rate for 97124?
Nebraska, at $30.15, effective 2026-07-01.
Do managed-care plans pay the same rate for 97124?
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.
Related Physician & professional codes
10005Physician and practitioner services (fee schedule) · 29 states10006Physician and practitioner services (fee schedule) · 29 states10007Physician and practitioner services (fee schedule) · 29 states10008Physician and practitioner services (fee schedule) · 29 states10009Physician and practitioner services (fee schedule) · 29 states10010Physician and practitioner services (fee schedule) · 29 states10021Physician and practitioner services (fee schedule) · 29 states10030Physician and practitioner services (fee schedule) · 29 states10060Physician and practitioner services (fee schedule) · 29 states10061Physician and practitioner services (fee schedule) · 29 states10080Physician and practitioner services (fee schedule) · 29 states10081Physician and practitioner services (fee schedule) · 29 states
Track 97124 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.