99509 Medicaid reimbursement rates by state
In-home personal care visit. 5 state Medicaid programs publish a fee-for-service rate for 99509 at the aide level. Rates run from $0.89 in Massachusetts to $101.14 in Virginia, with a median of $18.00.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 5
- Median rate
- $18.00units vary by state
- Highest
- $101.14Virginia
- Medicare (non-facility)
- —not on the physician fee schedule
99509 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 |
|---|---|---|---|---|---|---|
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia developmental disability waivers (Building Independence, Family and Individual Supports, Community Living) | $101.14since 2024-07-01 | hour | $101.14 | Paid by the state, outside plans | — | DMAS Developmental Disabilities Waiver S |
| WisconsinAide or attendant (HHA, CNA, PCA, home care aide) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $52.72since 2022-01-01 | — | — | Plans may pay no more | — | ForwardHealth max fee schedule: Home Car |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Residential Options Waiver (ROW, OCDD/OIDD 1915(c) waiver) | $18.00since 2025-11-18 | 15 min | $72.00 | Paid by the state, outside plans | — | Residential Options Waiver rate and proc |
| North CarolinaAide or attendant (HHA, CNA, PCA, home care aide) · North Carolina Medicaid Direct (fee-for-service) | $5.96since 2023-07-01 | 15 min. | $23.84 | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Personal Care |
| MassachusettsAide or attendant (HHA, CNA, PCA, home care aide) · MassHealth home- and community-based services waivers (101 CMR 359 / 449) | $0.89since 2022-07-01 | 15 min | $3.56 | Not classified | — | Rates for Certain Home- and Community-Ba |
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 99509?
It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $18.00. Virginia pays the most ($101.14 per hour) and Massachusetts the least ($0.89 per 15 min).
Which state pays the highest Medicaid rate for 99509?
Virginia, at $101.14 per hour ($101.14 per hour), effective 2024-07-01.
Do managed-care plans pay the same rate for 99509?
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.