97533 Medicaid reimbursement rates by state
Sensory processing therapy. 22 state Medicaid programs publish a fee-for-service rate for 97533 at the therapist ot level. Rates run from $18.93 in Wisconsin to $3,510.00 in New Jersey, with a median of $38.37.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 22
- Median rate
- $38.37units vary by state
- Highest
- $3,510.00New Jersey
- Medicare (non-facility)
- $54.65–$82.032026 physician fee schedule
97533 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 |
|---|---|---|---|---|---|---|
| New JerseyOccupational therapist · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $3,510.00⚠ over 3× mediansince 2025-12-01 | 15 min | $14,040.00 | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $57.43since 2025-10-01 | 15 min | $229.72 | Plans negotiate; applies out of network | 97% | AHCCCS Arizona Health Care Cost Containm |
| IndianaOccupational therapist · Indiana Medicaid (fee-for-service) | $56.84since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| MissouriOccupational therapist · Missouri MO HealthNet (fee-for-service) | $55.12since 2022-07-01 | 15 min | $220.48 | Paid by the state, outside plans | — | MO HealthNet fee schedule: First Steps |
| VirginiaOccupational therapist · Virginia Medicaid (fee-for-service, DMAS) | $52.66since 2026-07-01 | 15 min | $210.64 | Plans negotiate; applies out of network | 88% | DMAS procedure fee file cptmedical4.csv |
| ColoradoOccupational therapist · Child Health Plan Plus (CHP+, Colorado's CHIP) | $52.41since 2026-07-01 | 15 min | $209.64 | Plans negotiate; applies out of network | 82% | Child Health Plan Plus FY 2026-2027 Fee |
| MassachusettsOccupational therapist · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $49.38since 2025-06-06 | 15 min | $197.52 | Plans negotiate; applies out of network | 71–78% | Rates for Restorative Services (effectiv |
| LouisianaOccupational therapist · Louisiana Medicaid (fee-for-service) | $48.26since 2025-07-01 | 15 min | $193.04 | Plans must pay at least this | 83–87% | Louisiana Medicaid Professional Services |
| MichiganOccupational therapist · Michigan Medicaid (fee-for-service) | $47.68since 2026-01-01 | 15 min | $190.72 | Plans negotiate; applies out of network | 80–84% | MDHHS Occupational Therapy Fee Schedule |
| MinnesotaOccupational therapist · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $47.60since 2026-02-01 | 15 min | $190.40 | Plans negotiate; applies out of network | 77% | MHCP Fee Schedule - Current Fee Schedule |
| IllinoisOccupational therapist · Illinois Medicaid (HFS fee-for-service) | $39.09since 2024-04-01 | 15 min | $156.36 | Plans negotiate; applies out of network | 63–68% | HFS Practitioner Fee Schedule (effective |
| WashingtonOccupational therapist · Washington Apple Health (Medicaid) fee-for-service | $37.65since 2026-07-01 | 15 min | $150.60 | Plans negotiate; applies out of network | 53–60% | HCA Habilitative services fee schedule ( |
| KentuckyOccupational therapist · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $35.59since 2026-01-01 | 15 min | $142.36 | Plans negotiate; applies out of network | 64% | KY Medicaid OT fee schedule (2026Occupat |
| GeorgiaOccupational therapist · Georgia Medicaid (fee-for-service) | $27.18since 2023-07-01 | 15 min | $108.72 | Plans negotiate; applies out of network | 44–48% | Max Allow Payment_OutP Site of Service J |
| MarylandOccupational therapist · Maryland Medicaid (fee-for-service, MDH) | $25.68since 2026-01-01 | 15 min | $102.72 | Not classified | 40–42% | Maryland Medicaid Professional Services |
| ConnecticutOccupational therapist · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $25.65since 2015-04-01 | 15 min | $102.60 | Not classified | 40% | CMAP fee schedule: Clinic - Rehabilitati |
| CaliforniaOccupational therapist · California Medi-Cal (fee-for-service) | $24.17since 2026-10-01 | 15 min | $96.68 | Plans negotiate; applies out of network | 29–37% | Medi-Cal Rates (Rates files zip: rates_d |
| OhioOccupational therapist · Ohio Medicaid School Program (school-based services) | $22.04since 2020-06-12 | 15 min | $88.16 | Paid by the state, outside plans | 39% | Appendix DD to OAC 5160-1-60 (Non-Instit |
| North CarolinaOccupational therapist · North Carolina Medicaid Direct (fee-for-service) | $21.70since 2025-10-01 | 15 min | $86.80 | Paid by the state, outside plans | 38% | NC Medicaid fee schedule 'Children Devel |
| IowaOccupational therapist · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $21.42since 2012-06-11 | 15 min | $85.68 | Paid by the state, outside plans | 38% | Iowa Medicaid fee schedule #40 AREA EDUC |
| South CarolinaOccupational therapist · South Carolina Healthy Connections Medicaid (fee-for-service) | $20.13since 2011-07-11 | 15 min | $80.52 | Not classified | 35% | SCDHHS Base Physician Fee Schedule (sche |
| WisconsinOccupational therapist · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $18.93since 2008-07-01 | 15 min | $75.72 | Plans negotiate; applies out of network | 32% | ForwardHealth max fee schedule: Therapy- |
Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of 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 97533?
It depends on the state. Of the 22 states with a published fee-for-service rate, the median is $38.37. New Jersey pays the most ($3,510.00 per 15 min) and Wisconsin the least ($18.93 per 15 min).
Which state pays the highest Medicaid rate for 97533?
New Jersey, at $3,510.00 per 15 min ($14,040.00 per hour), effective 2025-12-01.
How do Medicaid rates for 97533 compare with Medicare?
Where the billing units match, Medicaid pays between 32% and 97% of the 2026 Medicare physician fee schedule amount for the state (non-facility).
Do managed-care plans pay the same rate for 97533?
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.