H0023 Medicaid reimbursement rates by state
Behavioral health outreach service. 9 state Medicaid programs publish a fee-for-service rate for H0023 at the case manager level. Rates run from $7.66 in Kentucky to $367.31 in Virginia, with a median of $31.14.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 9
- Median rate
- $31.14units vary by state
- Highest
- $367.31Virginia
- Medicare (non-facility)
- —not on the physician fee schedule
H0023 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 |
|---|---|---|---|---|---|---|
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $367.31⚠ over 3× mediansince 2021-07-01 | — | — | Plans must pay at least this | — | DMAS procedure fee file hcpcmedical.csv |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $112.96since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | HCA Mental health and psychology service |
| MassachusettsCase manager / support coordinator · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $76.13since 2025-09-01 | — | — | Plans must pay at least this | — | Rates for Certain Children’s Behavioral |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $62.97since 2024-07-01 | unit | — | Plans negotiate; applies out of network | — | OHP FFS behavioral health fee schedule ( |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Intellectual Disability and Related Disabilities (ID/RD) Waiver (SC.0237, DDSN-operated) | $31.14since 2025-11-01 | 30 min | $62.28 | Paid by the state, outside plans | — | SCDHHS HCBS Waivers Fee Schedule (Effect |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $29.32since 2025-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS behavioral health outpatient MCO capped fee schedule | $14.02since 2026-01-01 | — | — | Suggested schedule for plans | — | AHCCCS MCO Fee Schedule Final MCO Behavi |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $11.94since 2019-07-01 | — | — | Paid by the state, outside plans | — | MO HealthNet fee schedule: Community Psy |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Supports for Community Living (SCL) 1915(c) waiver | $7.66since 2025-01-01 | 15 min | $30.64 | Paid by the state, outside plans | — | DMS Home and Community Based Services Wa |
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 H0023?
It depends on the state. Of the 9 states with a published fee-for-service rate, the median is $31.14. Virginia pays the most ($367.31) and Kentucky the least ($7.66 per 15 min).
Which state pays the highest Medicaid rate for H0023?
Virginia, at $367.31, effective 2021-07-01.
Do managed-care plans pay the same rate for H0023?
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.