G9002 Medicaid reimbursement rate by state (2026)

• Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for G9002, so the order is by published amount and is not a like-for-like rank.
• Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 9 of the 13 states list more than one rate for G9002, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
• Unit. Of the 13 states, 3 publish G9002 per 15 min and 1 per month, and 9 schedules print no unit at all (a flat amount per service).
• Per hour. Time-based units are converted to an hour of service (four 15-minute units make an hour). 3 of the 13 states bill G9002 by time.
• Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
• % of Medicare. No Medicare physician fee schedule amount is on file for G9002, so there is no percentage.
• Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.

Published rates for G9002 run from $6.01 in Alabama to $1,000.00 in Illinois. The two publish it in different units (month versus no unit printed), so part of that gap is the unit rather than the price. Half the states pay more than the median of $52.16 and half pay less. The usual reasons for a spread like this in other home & community services rates:

• Case management may be paid as a monthly rate, a per-contact rate or in 15-minute units.
• Home and community-based services are often paid under waivers, and each waiver can set its own rate for the same service.
• Some services are paid per 15 minutes in one state and per day or per month in another.

Timing matters too. 5 states set the current rate for G9002 in 2026 or later, while 4 states still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.

No managed-care plan publishes what it pays for G9002. What is public is the rule each state's plan contracts set, and that rule decides how much the published rate matters when you contract with a plan.

In 6 states, plans negotiate and the published rate is a benchmark or out-of-network default. In 1 state, the service is paid outside the plans or through a state-directed payment. The rule for the remaining 6 states is not classified yet.

• Plans negotiate; the published rate applies out of network (6 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.
• Paid by the state, outside the plans (1 state). Bill the state's Medicaid program, not the plan, at the published rate. There is no plan contract to negotiate for this service.

Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example Illinois managed care.

G9002 is a HCPCS Level II professional services code in the other home & community services line, billed mostly by case management agencies, adult day centers, respite providers and other home and community-based services. G codes describe professional services and procedures that have no CPT code, or that payers define more narrowly. Many are timed, so check the unit before comparing.

Units range from 15 minutes to a day or a month, so a per-unit comparison only holds when the states use the same unit.

Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.