G0146 Medicaid reimbursement rate by state (2026)
Principal illness navigation - peer support. Medicaid pays a median of $43.89 for G0146 across 6 states, from $11.59 in Kansas to $75.12 in Montana.
- States publishing
- 6
- National median
- $43.89units vary by state
- Lowest
- $11.59Kansas
- Highest
- $75.12Montana
What does Medicaid pay for G0146?
6 state Medicaid programs publish a fee-for-service rate for G0146. The national median is $43.89 (units differ between states). Montana pays the most, $75.12, and Kansas the least, $11.59, a 6.5x spread.
Medicare (non-facility, 2026 physician fee schedule): $50.02–$56.81 depending on the state's Medicare locality.
G0146 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 6 states with every variant, modifier and effective date.
How to read this table
- Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for G0146, so the order is by published amount and is not a like-for-like rank.
- Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 3 of the 6 states list more than one rate for G0146, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
- Unit. None of the 6 schedules prints a separate unit for G0146, so each amount is a flat payment for one service as the code defines it.
- Per hour. G0146 is not billed in time units in these states, so no hourly figure is shown.
- Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
- % of Medicare. Medicare amounts exist for G0146, but no state's Medicaid unit matches Medicare's billing unit closely enough to compute a percentage.
- Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Why G0146 rates differ between states
Published rates for G0146 run from $11.59 in Kansas to $75.12 in Montana, a 6.5x gap in the same unit. Half the states pay more than the median of $43.89 and half pay less. The usual reasons for a spread like this in physician & professional rates:
- Many schedules pay differently by place of service (office versus facility) and by practitioner, and nurse practitioners and physician assistants are often paid a percentage of the physician amount.
- Some states pay physician services as a percentage of the Medicare fee schedule; others keep a schedule of their own that may not have been rebased for years.
- Each state sets its own physician conversion factor or fee for every code, and many update them on a state budget cycle rather than on Medicare's calendar.
Timing matters too. 4 states set the current rate for G0146 in 2026 or later. A state that has not updated its rate in years will drift down the ranking as others raise theirs.
What managed-care plans pay for G0146
No managed-care plan publishes what it pays for G0146. What is public is the rule each state's plan contracts set, and that rule decides how much the published rate matters when you contract with a plan.
In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 2 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 3 states is not classified yet.
- Plans negotiate; the published rate applies out of network (2 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.
- Plans must pay at least the published rate (1 state). The published rate is your floor. Negotiate up from it, and if a plan pays less, the contract provision is the basis for a payment dispute.
Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example Montana managed care.
Units and billing for G0146
G0146 is a HCPCS Level II professional services code in the physician & professional line, billed mostly by physicians, nurse practitioners, physician assistants and other licensed practitioners. G codes describe professional services and procedures that have no CPT code, or that payers define more narrowly. Many are timed, so check the unit before comparing.
Physician-fee-schedule codes are billed per service: one unit is one occurrence unless the code itself is defined by time or quantity. Where a state publishes separate facility and non-facility amounts, the non-facility (office) amount is usually higher because the practice carries the overhead.
Medicare's 2026 physician fee schedule pays $50.02–$56.81 for G0146 (non-facility), depending on the Medicare locality. That is a useful reference point, but Medicare and Medicaid can define the unit differently, so compare only where the units match.
Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.
Frequently asked questions
What does Medicaid pay for G0146?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $43.89. Montana pays the most ($75.12) and Kansas the least ($11.59).
Which state pays the highest Medicaid rate for G0146?
Montana, at $75.12, effective 2026-07-01.
Which state pays the lowest Medicaid rate for G0146?
Kansas, at $11.59, effective 2024-01-01.
What unit is G0146 billed in?
None of the 6 schedules prints a separate unit for G0146, so each amount is a flat payment for one service as the code defines it.
Do managed-care plans pay the same rate for G0146?
Not necessarily. In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 2 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 3 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.