H0016 Medicaid reimbursement rates by state
Alcohol and/or drug services; medical/somatic. 6 state Medicaid programs publish a fee-for-service rate for H0016 at the physician psychologist level. Rates run from $14.46 in Texas to $325.45 in Colorado, with a median of $183.87.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 6
- Median rate
- $183.87units vary by state
- Highest
- $325.45Colorado
- Medicare (non-facility)
- —not on the physician fee schedule
H0016 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 |
|---|---|---|---|---|---|---|
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $325.45since 2024-07-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Public Behavioral Health System (specialty mental health, SUD and ABA, paid fee-for-service through the Carelon ASO) | $310.76since 2024-07-01 | Initial Induction period | — | Paid by the state, outside plans | — | FY2025 PBHS Fee Schedule – SUD_7.1.2024 |
| KentuckyPhysician or licensed psychologist (incl. BCBA-D) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $217.15since 2024-04-01 | encounter | — | Plans negotiate; applies out of network | — | KY Medicaid Behavioral Health fee schedu |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $150.59since 2025-07-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $102.45since 2024-07-01 | unit | — | Plans negotiate; applies out of network | — | OHP FFS behavioral health fee schedule ( |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $14.46since 2026-03-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Outpa |
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 H0016?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $183.87. Colorado pays the most ($325.45) and Texas the least ($14.46).
Which state pays the highest Medicaid rate for H0016?
Colorado, at $325.45, effective 2024-07-01.
Do managed-care plans pay the same rate for H0016?
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.