97799 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 9 state Medicaid programs publish a fee-for-service rate for 97799 at the therapy assistant level. Rates run from $0.00 in Arkansas to $85.82 in Wisconsin, with a median of $21.00.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 9
- Median rate
- $21.00units vary by state
- Highest
- $85.82Wisconsin
- Medicare (non-facility)
- —not on the physician fee schedule
97799 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 |
|---|---|---|---|---|---|---|
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $85.82⚠ over 3× mediansince 2022-01-01 | — | — | Plans may pay no more | — | ForwardHealth max fee schedule: Home Car |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $29.49since 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) | $28.64since 2019-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $28.13since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Practitioner Fee Schedule (2026-01-01) |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $21.00since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $19.82since 2025-06-06 | — | — | Plans negotiate; applies out of network | — | Rates for Restorative Services (effectiv |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Children's Choice Waiver (OCDD/OIDD 1915(c) waiver for children with developmental disabilities) | $9.38since 2025-11-18 | 15 min | $37.52 | Paid by the state, outside plans | — | Children's Choice Waiver rate and proced |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $7.00since 2014-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| ArkansasPhysician or licensed psychologist (incl. BCBA-D) · Arkansas Medicaid (fee-for-service) | $0.00since 2025-06-13 | — | — | Not classified | — | Arkansas Medicaid Physician / CRNA / Fam |
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 97799?
It depends on the state. Of the 9 states with a published fee-for-service rate, the median is $21.00. Wisconsin pays the most ($85.82) and Arkansas the least ($0.00).
Which state pays the highest Medicaid rate for 97799?
Wisconsin, at $85.82, effective 2022-01-01.
Do managed-care plans pay the same rate for 97799?
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.