H0019 Medicaid reimbursement rates by state
Behavioral health; long-term residential (non-medical. 25 state Medicaid programs publish a fee-for-service rate for H0019 at the physician psychologist level. Rates run from $18.94 in Maryland to $1,003.95 in Oregon, with a median of $196.24.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 25
- Median rate
- $196.24units vary by state
- Highest
- $1,003.95Oregon
- Medicare (non-facility)
- —not on the physician fee schedule
H0019 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) | $1,003.95⚠ over 3× mediansince 2026-07-01 | day | — | Plans negotiate; applies out of network | — | OHP FFS behavioral health fee schedule ( |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $602.45⚠ over 3× mediansince 2024-07-01 | day | — | Plans must pay at least this | — | DMAS procedure fee file hcpcmedical.csv |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $573.39since 2026-01-01 | day | — | Plans must pass increases through | — | Intensive Residential Treatment Services |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal Specialty Mental Health Services (DHCS fee schedule for county Mental Health Plans) | $493.23since 2026-07-01 | 24 Hour | — | Paid by the state, outside plans | — | Medi-Cal Behavioral Health Fee Schedules |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $445.11since 2025-01-01 | day | — | Not classified | — | MaineCare Section 97 PNMI Appendix E Men |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $358.00since 2022-10-12 | day | — | Not classified | — | Arkansas Medicaid Adult Behavioral Healt |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $341.94since 2024-07-31 | day | — | Plans must pay at least this | — | Provider Type 20 Physician, MD., Osteopa |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $296.12since 2025-10-01 | day | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Enhanced Menta |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $287.19since 2025-07-01 | day | — | Not classified | — | Substance Use Disorder (Chemical Depende |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $249.04since 2025-01-01 | day | — | Plans must pay at least this | — | Fee Schedule for Behavioral Health Provi |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $230.00since 2020-01-01 | day | — | Plans negotiate; applies out of network | — | DMS CMHC Mental Health Substance Abuse f |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $217.81since 2025-12-01 | day | — | Not classified | — | SCDHHS RBHS Substance Use Services Fee S |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $196.24since 2026-07-01 | day | — | Plans must pay at least this | — | Rates for Certain Substance-Related and |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $196.21since 2026-01-01 | day | — | Plans negotiate; applies out of network | — | Specialized Therapeutic Services Fee Sch |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $195.20since 2026-07-01 | day | — | Plans negotiate; applies out of network | — | Nebraska Medicaid Mental Health and Subs |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $174.90since 2024-01-01 | day | — | Plans negotiate; applies out of network | — | HCA Substance use disorder fee schedule |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma ODMHSAS state-funded behavioral health services (non-Medicaid 'State Rate') | $160.00since 2022-07-01 | day | — | 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) | $142.70since 2025-01-01 | day | — | Paid by the state, outside plans | — | NJMMIS Procedure Master Listing CPTHCPCS |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $139.59since 2023-07-01 | day | — | Plans must pay at least this | — | MO HealthNet fee schedule: Comprehensive |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $137.52since 2020-01-01 | day | — | Plans negotiate; applies out of network | — | AHCCCS FFS Behavioral Health Outpatient |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $133.09since 2026-01-01 | day | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $131.28since 2026-07-01 | day | — | Not classified | — | Health First Colorado Physician Fee Sche |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid (KMAP fee-for-service schedule) | $131.04since 2022-07-01 | day | — | Plans must pay at least this | — | KMAP Fee Schedule TXIX Medicaid (FeeSche |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $94.26since 2024-01-01 | day | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #63 BEHAVIORA |
| 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) | $18.94since 2024-07-01 | day | — | Paid by the state, outside plans | — | FY2025 PBHS Fee Schedule – PRP and Speci |
Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 H0019?
It depends on the state. Of the 25 states with a published fee-for-service rate, the median is $196.24. Oregon pays the most ($1,003.95 per day) and Maryland the least ($18.94 per day).
Which state pays the highest Medicaid rate for H0019?
Oregon, at $1,003.95 per day, effective 2026-07-01.
Do managed-care plans pay the same rate for H0019?
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.
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Track H0019 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.