G0238 Medicaid reimbursement rates by state
Therapeutic procedures to improve respiratory function. 19 state Medicaid programs publish a fee-for-service rate for G0238 at the agency level. Rates run from $5.16 in Rhode Island to $55.08 in Utah, with a median of $9.10.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 19
- Median rate
- $9.10per 15 min
- Highest
- $55.08Utah
- Medicare (non-facility)
- $9.64–$12.732026 physician fee schedule
G0238 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 |
|---|---|---|---|---|---|---|
| UtahAgency provider · Utah Medicaid (fee-for-service, Traditional plan) | $55.08⚠ over 3× mediansince 2022-01-01 | 15 min | $220.32 | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $24.75since 2022-08-01 | 15 min | $99.00 | Not classified | — | Arkansas Medicaid Ventilator Equipment F |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $17.19since 2026-01-01 | 15 min | $68.76 | Plans negotiate; applies out of network | — | Respiratory Therapy Services Fee Schedul |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $17.00since 2016-07-01 | 15 min | $68.00 | Not classified | — | CMAP fee schedule: Special Services 7/1/ |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $16.71since 2007-07-01 | 15 min | $66.84 | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service | $11.33since 2026-06-01 | 15 min | $45.32 | Plans negotiate; applies out of network | — | Medicaid Fee-For-Service (FFS) Fee Sched |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Big Sky Waiver for elderly and physically disabled adults (1915(c), fee-for-service) | $9.78since 2026-07-01 | 15 min | $39.12 | Not classified | — | Montana Healthcare Programs fee schedule |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $9.49since 2026-01-01 | 15 min | $37.96 | Not classified | — | Vermont Medicaid Fee Schedule - HCPCS (i |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $9.46since 2026-07-01 | 15 min | $37.84 | Plans must pay at least this | — | SoonerCare Title XIX Fee Schedule |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $9.10since 2026-01-01 | 15 min | $36.40 | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $8.74since 2026-02-01 | 15 min | $34.96 | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $8.57since 2010-09-01 | 15 min | $34.28 | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $7.93since 2026-07-01 | 15 min | $31.72 | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $7.89since 2023-07-01 | 15 min | $31.56 | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $7.32since 2026-04-01 | 15 min | $29.28 | Plans negotiate; applies out of network | — | BMS RBRVS 2026 Effective 4/1/26 - 3/31/2 |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $6.41since 2024-04-01 | 15 min | $25.64 | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $5.68since 2024-01-01 | 15 min | $22.72 | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $5.25since 2024-07-01 | 15 min | $21.00 | Plans negotiate; applies out of network | — | SCDHHS Nurse Midwives Fee Schedule (sche |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service) | $5.16since 2002-01-01 | 15 min | $20.64 | Plans negotiate; applies out of network | — | RI Medicaid Interactive Fee For Service |
Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 G0238?
It depends on the state. Of the 19 states with a published fee-for-service rate, the median is $9.10 per 15 min. Utah pays the most ($55.08 per 15 min) and Rhode Island the least ($5.16 per 15 min).
Which state pays the highest Medicaid rate for G0238?
Utah, at $55.08 per 15 min ($220.32 per hour), effective 2022-01-01.
Do managed-care plans pay the same rate for G0238?
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.