G0176 Medicaid reimbursement rates by state
Activity therapy, such as music, dance. 10 state Medicaid programs publish a fee-for-service rate for G0176 at the agency level. Rates run from $7.50 in Kansas to $1,500.00 in South Dakota, with a median of $21.66.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 10
- Median rate
- $21.66units vary by state
- Highest
- $1,500.00South Dakota
- Medicare (non-facility)
- —not on the physician fee schedule
G0176 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 |
|---|---|---|---|---|---|---|
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Family Support 360 Waiver (1915(c) developmental disabilities, in-home supports) | $1,500.00since 2025-07-01 | year | — | Not classified | — | South Dakota Medicaid Family Support 360 |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $45.12since 2025-01-01 | hour | $45.12 | Plans must pay at least this | — | Fee Schedule for Behavioral Health Provi |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $35.00since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| District of ColumbiaAny qualified provider (rate does not vary by provider) · DC Intellectual and Developmental Disabilities (IDD) 1915(c) waiver (DDS) | $31.79since 2026-07-01 | — | — | Not classified | — | REFRP00178CSV - Medical Fee Schedule Rep |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $26.17since 2024-07-01 | Per Session, 45 Minutes or More | — | Plans negotiate; applies out of network | — | OHP FFS behavioral health fee schedule ( |
| ColoradoAny qualified provider (rate does not vary by provider) · Colorado Children's Habilitation Residential Program waiver (CHRP) | $17.15since 2026-07-01 | 15 min | $68.60 | Paid by the state, outside plans | — | CwCHN, CHRP (effective July 1, 2026) |
| WisconsinAgency provider · Wisconsin Children's Long-Term Support (CLTS) Waiver (fee-for-service, statewide uniform rate schedule) | $14.00since 2025-01-01 | Session | — | Paid by the state, outside plans | — | CLTS Waiver Statewide Uniform Rate Sched |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Children's Choice Waiver (OCDD/OIDD 1915(c) waiver for children with developmental disabilities) | $13.75since 2025-11-18 | 15 min | $55.00 | Paid by the state, outside plans | — | Children's Choice Waiver rate and proced |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania ODP intellectual disability/autism waivers (Consolidated, Community Living, Person/Family Directed Support) and base-funded services | $12.11since 2024-01-01 | per 15-minute unit | — | Not classified | — | 53 Pa.B. 7099: Fee Schedule Rates for Se |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $7.50since 2004-01-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
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 G0176?
It depends on the state. Of the 10 states with a published fee-for-service rate, the median is $21.66. South Dakota pays the most ($1,500.00 per year) and Kansas the least ($7.50).
Which state pays the highest Medicaid rate for G0176?
South Dakota, at $1,500.00 per year, effective 2025-07-01.
Do managed-care plans pay the same rate for G0176?
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.