H1005 Medicaid reimbursement rates by state
Prenatal care, at-risk enhanced service package. 5 state Medicaid programs publish a fee-for-service rate for H1005 at the physician psychologist level. Rates run from $55.00 in Kansas to $432.90 in Colorado, with a median of $130.21.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 5
- Median rate
- $130.21units vary by state
- Highest
- $432.90Colorado
- Medicare (non-facility)
- —not on the physician fee schedule
H1005 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) | $432.90⚠ over 3× mediansince 2026-07-01 | — | — | Not classified | — | July 2026 Prenatal Plus and Special Conn |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $164.00since 2022-01-01 | — | — | Plans negotiate; applies out of network | — | Appendix DD to OAC 5160-1-60 (Non-Instit |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $130.21since 2026-07-01 | — | — | Plans must pay at least this | — | Rates for Certain Substance-Related and |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $89.91since 2018-09-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $55.00since 2002-01-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
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 H1005?
It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $130.21. Colorado pays the most ($432.90) and Kansas the least ($55.00).
Which state pays the highest Medicaid rate for H1005?
Colorado, at $432.90, effective 2026-07-01.
Do managed-care plans pay the same rate for H1005?
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.