H1001 Medicaid reimbursement rates by state
Prenatal care, at-risk enhanced service. 10 state Medicaid programs publish a fee-for-service rate for H1001 at the physician psychologist level. Rates run from $4.65 in Iowa to $439.32 in Illinois, with a median of $62.09.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 10
- Median rate
- $62.09units vary by state
- Highest
- $439.32Illinois
- Medicare (non-facility)
- —not on the physician fee schedule
H1001 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 |
|---|---|---|---|---|---|---|
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $439.32⚠ over 3× mediansince 2024-09-05 | — | — | Plans negotiate; applies out of network | — | HFS Licensed Certified Professional Midw |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $203.00since 2026-01-01 | — | — | Plans must pass increases through | — | MHCP Fee Schedule (Wayback capture 20260 |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $176.00since 2016-01-01 | — | — | Plans negotiate; applies out of network | — | SCDHHS Nurse Midwives Fee Schedule (sche |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $108.00since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Licensed Midwife Fee Schedule (2026-01-0 |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $92.09since 2024-10-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Maternal Infant Health Program Dat |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $32.09since 2019-07-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Practitioner |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $18.72since 2025-07-01 | — | — | Plans must pay at least this | — | SoonerCare Title XIX Fee Schedule |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $12.95since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Appendix DD to OAC 5160-1-60 (Non-Instit |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $12.50since 2025-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $4.65since 2018-09-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
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 H1001?
It depends on the state. Of the 10 states with a published fee-for-service rate, the median is $62.09. Illinois pays the most ($439.32) and Iowa the least ($4.65).
Which state pays the highest Medicaid rate for H1001?
Illinois, at $439.32, effective 2024-09-05.
Do managed-care plans pay the same rate for H1001?
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.