G0318 Medicaid reimbursement rates by state
Prolonged home or residence evaluation and management.... 10 state Medicaid programs publish a fee-for-service rate for G0318 at the physician psychologist level. Rates run from $6.58 in Kansas to $47.89 in Montana, with a median of $23.39.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 10
- Median rate
- $23.39per 15 min
- Highest
- $47.89Montana
- Medicare (non-facility)
- $32.04–$37.512026 physician fee schedule
G0318 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 |
|---|---|---|---|---|---|---|
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $47.89since 2026-07-01 | 15 min | $191.56 | Not classified | — | Montana Healthcare Programs fee schedule |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $30.94since 2026-07-01 | 15 min | $123.76 | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $29.92since 2025-01-01 | 15 min | $119.68 | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $27.21since 2023-01-01 | 15 min | $108.84 | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $23.52since 2026-01-01 | 15 min | $94.08 | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $23.25since 2023-01-01 | 15 min | $93.00 | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $22.81since 2023-01-01 | 15 min | $91.24 | Plans negotiate; applies out of network | — | Appendix DD to OAC 5160-1-60 (Non-Instit |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $21.69since 2026-07-01 | 15 min | $86.76 | Plans must pay at least this | — | HCA Enhanced pediatric fee schedule (enh |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $13.71since 2026-07-01 | 15 min | $54.84 | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $6.58since 2023-01-01 | 15 min | $26.32 | Not classified | — | KMAP Fee Schedule QMB 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 G0318?
It depends on the state. Of the 10 states with a published fee-for-service rate, the median is $23.39 per 15 min. Montana pays the most ($47.89 per 15 min) and Kansas the least ($6.58 per 15 min).
Which state pays the highest Medicaid rate for G0318?
Montana, at $47.89 per 15 min ($191.56 per hour), effective 2026-07-01.
Do managed-care plans pay the same rate for G0318?
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.