H0001 Medicaid reimbursement rates by state
Alcohol and/or drug assessment. 25 state Medicaid programs publish a fee-for-service rate for H0001 at the physician psychologist level. Rates run from $15.13 in Florida to $229.13 in Oregon, with a median of $94.00.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 25
- Median rate
- $94.00units vary by state
- Highest
- $229.13Oregon
- Medicare (non-facility)
- —not on the physician fee schedule
H0001 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 |
|---|---|---|---|---|---|---|
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $229.13since 2024-07-01 | unit | — | Plans negotiate; applies out of network | — | OHP FFS behavioral health fee schedule ( |
| CaliforniaPhysician or licensed psychologist (incl. BCBA-D) · California Drug Medi-Cal Organized Delivery System (DHCS county fee schedule / interim rates) | $210.33since 2026-07-01 | — | — | Paid by the state, outside plans | — | Medi-Cal Behavioral Health Fee Schedules |
| South CarolinaPhysician or licensed psychologist (incl. BCBA-D) · South Carolina Healthy Connections Medicaid (fee-for-service) | $198.94since 2025-12-01 | — | — | Not classified | — | SCDHHS RBHS Substance Use Services Fee S |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Problem Gambling Fund (state-funded gambling treatment, claims through the Carelon ASO) | $179.55since 2021-11-01 | — | — | Not classified | — | FY2022 PBHS Fee Schedule – SUD Gambling_ |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $162.24since 2018-07-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $161.59since 2024-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Physician-related services fee sched |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $146.85since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Child and Adolescent Health Center |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $139.46since 2026-02-09 | — | — | Plans must pay at least this | — | Provider Type 20 Physician, MD., Osteopa |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $136.90since 2022-07-01 | — | — | Paid by the state, outside plans | — | MO HealthNet fee schedule: Comprehensive |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid (KMAP fee-for-service schedule) | $135.20since 2022-07-01 | — | — | Plans must pay at least this | — | KMAP Fee Schedule TXIX Medicaid (FeeSche |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $107.75since 2025-06-13 | — | — | Not classified | — | Arkansas Medicaid Nurse Practitioner Fee |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $104.17since 2021-07-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| KentuckyPhysician or licensed psychologist (incl. BCBA-D) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $94.00since 2020-01-01 | encounter | — | Plans negotiate; applies out of network | — | DMS CMHC Mental Health Substance Abuse f |
| NebraskaPhysician or licensed psychologist (incl. BCBA-D) · Nebraska Medicaid (fee-for-service) | $93.88since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid Mental Health and Subs |
| OhioLicensed mental health clinician (LCSW, LMFT, LPC, licensed practitioner) · Ohio Medicaid (fee-for-service) | $87.07since 2024-01-01 | encounter | — | Plans expected to pay at least this | — | OAC 5160-27-03 Appendix A, Community Beh |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $80.18since 2025-01-01 | Unit = 1 Service | — | Plans must pay at least this | — | Fee Schedule for Behavioral Health Provi |
| LouisianaBachelor's-level staff · Louisiana Medicaid (fee-for-service) | $78.03since 2026-01-01 | visit | — | Plans must pay at least this | — | Specialized Behavioral Health Services f |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $65.27since 2022-03-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Outpa |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $33.89since 2022-01-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Mntl Hlt |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $33.10since 2026-07-01 | — | — | Plans must pay at least this | — | Rates for Certain Substance-Related and |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS behavioral health outpatient MCO capped fee schedule | $32.86since 2026-10-01 | — | — | Suggested schedule for plans | — | AHCCCS MCO Fee Schedule Final MCO Behavi |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma ODMHSAS state-funded behavioral health services (non-Medicaid 'State Rate') | $25.32since 2024-05-22 | encounter | — | Not classified | — | ODMHSAS PICIS 'Rates and Codes for Agenc |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $24.50since 2025-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| North CarolinaPhysician or licensed psychologist (incl. BCBA-D) · North Carolina Medicaid Direct (fee-for-service) | $19.22since 2022-01-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Physician Serv |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $15.13since 2026-01-01 | per assessment | — | Plans negotiate; applies out of network | — | Community Behavioral Health Services Fee |
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 H0001?
It depends on the state. Of the 25 states with a published fee-for-service rate, the median is $94.00. Oregon pays the most ($229.13 per unit) and Florida the least ($15.13 per per assessment).
Which state pays the highest Medicaid rate for H0001?
Oregon, at $229.13 per unit, effective 2024-07-01.
Do managed-care plans pay the same rate for H0001?
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 Behavioral health codes
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Track H0001 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.