97140 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 28 state Medicaid programs publish a fee-for-service rate for 97140 at the therapy assistant level. Rates run from $9.84 in Kentucky to $32.90 in Nebraska, with a median of $21.51.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 28
- Median rate
- $21.51units vary by state
- Highest
- $32.90Nebraska
- Medicare (non-facility)
- $25.92–$34.912026 physician fee schedule
97140 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) | $32.90since 2026-07-01 | 15 min | $131.60 | Plans negotiate; applies out of network | 124% | Nebraska Medicaid fee schedule 471-000-5 |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $27.06since 2022-01-01 | 15 min | $108.24 | Plans negotiate; applies out of network | 100% | ForwardHealth max fee schedule: Therapy- |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $26.13since 2026-10-01 | 15 min | $104.52 | Plans negotiate; applies out of network | 96% | AHCCCS Arizona Health Care Cost Containm |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $26.00since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $25.44since 2019-09-01 | 15 min | $101.76 | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $24.67since 2026-01-01 | 15 min | $98.68 | Not classified | 85–88% | Maryland Medicaid Professional Services |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $24.58since 2026-07-01 | 15 min | $98.32 | Plans must pay at least this | 94% | SoonerCare Title XIX Fee Schedule |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $24.02since 2026-07-01 | 15 min | $96.08 | Plans negotiate; applies out of network | 88% | DMAS procedure fee file cptmedical4.csv |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $23.26since 2026-07-01 | 15 min | $93.04 | Plans negotiate; applies out of network | 81% | Child Health Plan Plus FY 2026-2027 Fee |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $23.21since 2024-08-01 | 15 min | $92.84 | Paid by the state, outside plans | 88% | KMAP Fee Schedule MKN Medicaid (FeeSched |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $22.98since 2023-07-01 | 15 min | $91.92 | Plans negotiate; applies out of network | 82–87% | Max Allow Payment_OutP Site of Service J |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $22.40since 2026-02-01 | 15 min | $89.60 | Plans negotiate; applies out of network | 76–81% | OHP FFS medical-dental fee schedule (fee |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $22.21since 2026-10-01 | 15 min | $88.84 | Plans negotiate; applies out of network | 64–76% | Medi-Cal Rates (Rates files zip: rates_d |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $21.67since 2025-07-01 | 15 min | $86.68 | Plans must pay at least this | 80–83% | Louisiana Medicaid Professional Services |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $21.35since 2026-02-01 | 15 min | $85.40 | Plans negotiate; applies out of network | 77% | MHCP Fee Schedule - Current Fee Schedule |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $21.25since 2025-10-01 | 15 min | $85.00 | Plans negotiate; applies out of network | 79% | NC Medicaid fee schedule 'Occupational T |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $21.03since 1999-01-03 | 15 min | $84.12 | Plans negotiate; applies out of network | 74–79% | PA DHS PROMISe Outpatient Fee Schedule ( |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $20.90since 2026-01-01 | 15 min | $83.60 | Not classified | 72% | 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) | $20.85since 2020-05-01 | 15 min | $83.40 | Plans must pay at least this | 79% | Iowa Medicaid fee schedule #50 NURSE PRA |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $20.64since 2026-10-01 | 15 min | $82.56 | Plans negotiate; applies out of network | 67–72% | Emergency Adoption (date filed: Septembe |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $20.49since 2022-07-01 | 15 min | $81.96 | Plans must pay at least this | 76–79% | MO HealthNet fee schedule: Podiatry |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $20.10since 2011-07-11 | 15 min | $80.40 | Not classified | 75% | SCDHHS Base Physician Fee Schedule (sche |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $17.68since 2026-01-01 | 15 min | $70.72 | Plans negotiate; applies out of network | 64–66% | MDHHS Occupational Therapy Fee Schedule |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $17.43since 2024-04-01 | 15 min | $69.72 | Plans negotiate; applies out of network | 61–65% | HFS Practitioner Fee Schedule (effective |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $16.82since 2026-07-01 | 15 min | $67.28 | Plans negotiate; applies out of network | 54–59% | HCA Habilitative services fee schedule ( |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid School Program (school-based services) | $14.13since 2020-06-12 | 15 min | $56.52 | Paid by the state, outside plans | 53% | Appendix DD to OAC 5160-1-60 (Non-Instit |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $14.03since 2026-07-01 | 15 min | $56.12 | Not classified | 46–48% | NJMMIS Procedure Master Listing CPTHCPCS |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $9.84since 2026-01-01 | 15 min | $39.36 | Plans negotiate; applies out of network | 37% | KY Medicaid OT fee schedule (2026Occupat |
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 97140?
It depends on the state. Of the 28 states with a published fee-for-service rate, the median is $21.51. Nebraska pays the most ($32.90 per 15 min) and Kentucky the least ($9.84 per 15 min).
Which state pays the highest Medicaid rate for 97140?
Nebraska, at $32.90 per 15 min ($131.60 per hour), effective 2026-07-01.
How do Medicaid rates for 97140 compare with Medicare?
Where the billing units match, Medicaid pays between 37% and 124% of the 2026 Medicare physician fee schedule amount for the state (non-facility).
Do managed-care plans pay the same rate for 97140?
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 97140 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.