H2016 Medicaid reimbursement rates by state
Comprehensive community support services, per diem. 8 state Medicaid programs publish a fee-for-service rate for H2016. Rates run from $6.06 in Minnesota to $229.58 in Missouri, with a median of $43.42.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 8
- Median rate
- $43.42units vary by state
- Highest
- $229.58Missouri
- Medicare (non-facility)
- —not on the physician fee schedule
H2016 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 |
|---|---|---|---|---|---|---|
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $229.58⚠ over 3× mediansince 2026-07-01 | day | — | Paid by the state, outside plans | — | MO HealthNet fee schedule: Comprehensive |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey DDD Community Care Program (CCP) for adults with IDD | $189.33⚠ over 3× mediansince 2026-01-01 | day | — | Paid by the state, outside plans | — | Quick Guide - FY26 DSP & Supervisor Rate |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS behavioral health outpatient MCO capped fee schedule | $90.60since 2026-10-01 | — | — | Suggested schedule for plans | — | AHCCCS MCO Fee Schedule Final MCO Behavi |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $45.21since 2024-01-01 | day | — | Plans must pay at least this | — | DMAS procedure fee file hcpcmedical.csv |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Intellectual Disability and Related Disabilities (ID/RD) Waiver (SC.0237, DDSN-operated) | $41.63since 2025-11-01 | 1/2 day = 2-3 hrs | — | Paid by the state, outside plans | — | SCDHHS HCBS Waivers Fee Schedule (Effect |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $34.84since 2022-07-01 | 1/4 hr | — | Plans negotiate; applies out of network | — | HFS Community Based Behavioral Services |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $23.15since 2026-07-01 | day | — | Plans must pay at least this | — | Rates for Certain Substance-Related and |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Essential Community Supports (ECS, state-funded) | $6.06since 2026-01-01 | day | — | Not classified | — | Long-Term Services and Supports Service |
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 H2016?
It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $43.42. Missouri pays the most ($229.58 per day) and Minnesota the least ($6.06 per day).
Which state pays the highest Medicaid rate for H2016?
Missouri, at $229.58 per day, effective 2026-07-01.
Do managed-care plans pay the same rate for H2016?
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.