G0454 Medicaid reimbursement rates by state
Physical therapy. 7 state Medicaid programs publish a fee-for-service rate for G0454 at the physician psychologist level. Rates run from $1.53 in Kansas to $37.70 in Texas, with a median of $8.61.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 7
- Median rate
- $8.61units vary by state
- Highest
- $37.70Texas
- Medicare (non-facility)
- $8.60–$9.862026 physician fee schedule
G0454 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 |
|---|---|---|---|---|---|---|
| TexasPhysical therapist · Texas Medicaid nursing facility (HHSC statewide rates) | $37.70since 2021-09-01 | unit | — | Plans negotiate; applies out of network | — | HHSC PFD NF rehabilitative and specializ |
| MontanaPhysician or licensed psychologist (incl. BCBA-D) · Montana Medicaid and HMK Plus (fee-for-service) | $12.68since 2026-07-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $8.64since 2016-01-01 | — | — | Plans negotiate; applies out of network | — | Appendix DD to OAC 5160-1-60 (Non-Instit |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service | $8.61since 2026-06-01 | — | — | Plans negotiate; applies out of network | — | Medicaid Fee-For-Service (FFS) Fee Sched |
| District of ColumbiaAny qualified provider (rate does not vary by provider) · DC Medicaid (DHCF) fee-for-service | $7.89since 2026-01-01 | — | — | Not classified | — | REFRP00178CSV - Medical Fee Schedule Rep |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $7.50since 2026-01-01 | — | — | Not classified | — | Vermont Medicaid Fee Schedule - HCPCS (i |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $1.53since 2013-01-01 | — | — | 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 G0454?
It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $8.61. Texas pays the most ($37.70 per unit) and Kansas the least ($1.53).
Which state pays the highest Medicaid rate for G0454?
Texas, at $37.70 per unit, effective 2021-09-01.
Do managed-care plans pay the same rate for G0454?
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.