G0476 Medicaid reimbursement rates by state

Physical therapy. 17 state Medicaid programs publish a fee-for-service rate for G0476 at the physician psychologist level. Rates run from $11.95 in Kansas to $95.08 in Texas, with a median of $34.21.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing: 17
Median rate: $34.21units vary by state
Highest: $95.08Texas
Medicare (non-facility): —not on the physician fee schedule

G0476 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)	$95.08since 2021-09-01	unit	—	Paid by the state, outside plans	—	HHSC PFD NF rehabilitative and specializ
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)	$38.21since 2016-07-01	—	—	Plans negotiate; applies out of network	—	PA DHS PROMISe Outpatient Fee Schedule (
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)	$35.09since 2026-10-01	—	—	Plans negotiate; applies out of network	—	AHCCCS FFS Capped Fee Schedule: Clinical
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)	$35.09since 2020-01-01	—	—	Plans negotiate; applies out of network	—	MHCP Fee Schedule - Current Fee Schedule
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)	$35.09since 2020-01-01	—	—	Plans negotiate; applies out of network	—	KY Medicaid Clinical Lab fee schedule (2
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)	$35.09since 2023-07-01	—	—	Plans must pay at least this	—	New Mexico Medicaid Fee for Service HCPC
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service	$35.09since 2026-06-01	—	—	Plans negotiate; applies out of network	—	Medicaid Fee-For-Service (FFS) Fee Sched
MontanaIndependent (non-agency) provider · Montana Medicaid and HMK Plus (fee-for-service)	$35.08since 2025-04-01	—	—	Not classified	—	Montana Healthcare Programs fee schedule
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)	$34.21since 2025-01-01	—	—	Not classified	—	Vermont Medicaid Fee Schedule - HCPCS (i
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)	$33.70since 2017-01-01	—	—	Not classified	—	CMAP fee schedule: Lab October 2026
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)	$31.58since 2026-07-01	—	—	Plans negotiate; applies out of network	—	MO HealthNet fee schedule: Independent L
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)	$30.94since 2024-09-01	—	—	Plans negotiate; applies out of network	—	Rates for Clinical Laboratory Services (
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)	$29.05since 2023-01-01	—	—	Plans negotiate; applies out of network	—	MDHHS Child and Adolescent Health Center
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)	$28.07since 2025-01-01	—	—	Not classified	—	NJMMIS Procedure Master Listing CPTHCPCS
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)	$28.07since 2024-10-01	—	—	Plans negotiate; applies out of network	—	OHP FFS medical-dental fee schedule (fee
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)	$21.54since 2018-10-01	—	—	Plans negotiate; applies out of network	—	Lab Max Allowable (in Zipped 2018 Fee Sc
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule	$11.95since 2016-01-01	—	—	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 G0476?

It depends on the state. Of the 17 states with a published fee-for-service rate, the median is $34.21. Texas pays the most ($95.08 per unit) and Kansas the least ($11.95).

Which state pays the highest Medicaid rate for G0476?

Texas, at $95.08 per unit, effective 2021-09-01.

Do managed-care plans pay the same rate for G0476?

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.

Related Therapy (PT/OT/speech) codes

92507Speech therapy session (one person) · 45 states 92521Stuttering evaluation · 45 states 92522Articulation evaluation · 45 states 92523Articulation and language evaluation · 45 states 92524Voice evaluation · 45 states 92610Swallowing assessment · 45 states 97110Exercise therapy for strength and range of motion · 44 states 97163Physical therapy evaluation, level 3 of 3 · 44 states 97167Occupational therapy evaluation, level 3 of 3 · 44 states 97530Functional activity training · 44 states 92526Swallowing and feeding therapy · 43 states 97161Physical therapy evaluation, level 1 of 3 · 43 states

Track G0476 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.

Start free trial Pricing