G0109 Medicaid reimbursement rates by state
Diabetes outpatient self-management training services. 21 state Medicaid programs publish a fee-for-service rate for G0109 at the physician psychologist level. Rates run from $7.26 in Indiana to $16.64 in Arizona, with a median of $12.09.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 21
- Median rate
- $12.09per 30 min
- Highest
- $16.64Arizona
- Medicare (non-facility)
- $15.01–$20.042026 physician fee schedule
G0109 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 |
|---|---|---|---|---|---|---|
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $16.64since 2026-10-01 | 30 min | $33.28 | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $16.00since 2021-08-01 | 30 min | $32.00 | Plans negotiate; applies out of network | — | HFS Diabetes Prevention and Management F |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $14.29since 2026-01-01 | 30 min | $28.58 | Plans must pay at least this | — | Louisiana Medicaid Enhanced Professional |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $14.21since 2026-07-01 | 30 min | $28.42 | Plans must pay at least this | — | SoonerCare Title XIX Fee Schedule |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $13.92since 2020-01-01 | 30 min | $27.84 | Plans negotiate; applies out of network | — | KY Medicaid Physician fee schedule (2020 |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $13.68since 2023-10-01 | 30 min | $27.36 | Plans negotiate; applies out of network | — | eMedNY NYS Medicaid Vision Care Fee Sche |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $13.04since 2022-07-01 | 30 min | $26.08 | Plans must pay at least this | — | MO HealthNet fee schedule: Practitioner |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $12.92since 2026-02-01 | 30 min | $25.84 | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $12.26since 2026-10-01 | 30 min | $24.52 | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $12.16since 2026-07-01 | 30 min | $24.32 | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $12.09since 2026-02-01 | 30 min | $24.18 | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $12.07since 2021-09-01 | 30 min | $24.14 | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $11.68since 2026-10-01 | 30 min | $23.36 | Plans negotiate; applies out of network | — | Emergency Adoption (date filed: Septembe |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $11.35since 2026-07-01 | 30 min | $22.70 | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $11.15since 2022-01-01 | 30 min | $22.30 | Plans negotiate; applies out of network | — | Appendix DD to OAC 5160-1-60 (Non-Instit |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $11.11since 2023-10-01 | 30 min | $22.22 | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $10.89since 2024-01-01 | 30 min | $21.78 | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $10.22since 2026-01-01 | 30 min | $20.44 | Plans negotiate; applies out of network | — | MDHHS Local Health Department, January 2 |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $9.98since 2025-10-01 | 30 min | $19.96 | Plans must pay at least this | — | NC Medicaid fee schedule 'Nurse Practiti |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $9.75since 2026-07-01 | 30 min | $19.50 | Plans negotiate; applies out of network | — | HCA Diabetes education fee schedule (dia |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $7.26since 2026-01-01 | 30 min | $14.52 | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
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 G0109?
It depends on the state. Of the 21 states with a published fee-for-service rate, the median is $12.09 per 30 min. Arizona pays the most ($16.64 per 30 min) and Indiana the least ($7.26 per 30 min).
Which state pays the highest Medicaid rate for G0109?
Arizona, at $16.64 per 30 min ($33.28 per hour), effective 2026-10-01.
Do managed-care plans pay the same rate for G0109?
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 G0109 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.