G0155 Medicaid reimbursement rate by state (2026)

• Order. States are listed from the highest published rate to the lowest. A like-for-like rank only counts states that use the same unit: 11 of the 13 states publish G0155 per 15 min, enough to rank them against each other.
• Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 9 of the 13 states list more than one rate for G0155, 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. Of the 13 states, 11 publish G0155 per 15 min, 1 per hour/max and 1 per hour.
• Per hour. Time-based units are converted to an hour of service (four 15-minute units make an hour). 12 of the 13 states bill G0155 by time, with a median of $71.23 per hour.
• Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
• % of Medicare. No Medicare physician fee schedule amount is on file for G0155, so there is no percentage.
• Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.

Published rates for G0155 run from $14.58 in Alabama to $70.46 in Massachusetts. The two publish it in different units (Hour/Max versus 15 min), so part of that gap is the unit rather than the price. Half the states pay more than the median of $18.36 and half pay less. The usual reasons for a spread like this in hospice rates:

• Service-intensity add-ons and the split between the first days of care and later days change the daily amount.
• Medicaid hospice rates are generally set using the Medicare hospice methodology and adjusted by a wage index, so the differences between states mostly reflect local wage levels.

Timing matters too. 4 states set the current rate for G0155 in 2026 or later, while 2 states still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.

No managed-care plan publishes what it pays for G0155. 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 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 4 states, plans negotiate and the published rate is a benchmark or out-of-network default. In 1 state, the service is paid outside the plans or through a state-directed payment. The rule for the remaining 6 states is not classified yet.

• Plans negotiate; the published rate applies out of network (4 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 (2 states). 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.
• Paid by the state, outside the plans (1 state). Bill the state's Medicaid program, not the plan, at the published rate. There is no plan contract to negotiate for this service.

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 Massachusetts managed care.

G0155 is a HCPCS Level II professional services code in the hospice line, billed mostly by hospice agencies. 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.

Hospice is paid per day at one of four levels of care: routine home care, continuous home care (paid by the hour), inpatient respite and general inpatient care.

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.