H2021 Medicaid reimbursement rates by state
Community-based wrap-around services, per 15 minutes. 14 state Medicaid programs publish a fee-for-service rate for H2021 at the physician psychologist level. Rates run from $1.57 in Pennsylvania to $213.21 in California, with a median of $12.50.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 14
- Median rate
- $12.50units vary by state
- Highest
- $213.21California
- Medicare (non-facility)
- —not on the physician fee schedule
H2021 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 |
|---|---|---|---|---|---|---|
| CaliforniaPhysician or licensed psychologist (incl. BCBA-D) · California Drug Medi-Cal in State Plan (non-ODS) counties | $213.21⚠ over 3× mediansince 2026-07-01 | 15 min | $852.84 | Paid by the state, outside plans | — | Medi-Cal Behavioral Health Fee Schedules |
| LouisianaPhysician or licensed psychologist (incl. BCBA-D) · Louisiana Medicaid (fee-for-service) | $177.68⚠ over 3× mediansince 2025-03-01 | 15 min | $710.72 | Plans must pay at least this | — | Specialized Behavioral Health Services f |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $70.00⚠ over 3× mediansince 2003-06-20 | 15 min | $280.00 | Not classified | — | DMAS procedure fee file hcpcmedical.csv |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $29.21since 2024-07-01 | 15 min | $116.84 | Plans expected to pay at least this | — | OHP FFS behavioral health fee schedule ( |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $24.63since 2026-10-01 | 15 min | $98.52 | Plans negotiate; applies out of network | — | AHCCCS FFS Fee Schedule Final FFS Behavi |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Money Follows the Person (PRTF transition track) | $23.53since 2012-10-01 | 15 min | $94.12 | Paid by the state, outside plans | — | IHCP Professional Fee Schedule (Last Upd |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Children's Long-Term Support (CLTS) Waiver (fee-for-service, statewide uniform rate schedule) | $13.13since 2025-01-01 | 15-min. | — | Paid by the state, outside plans | — | CLTS Waiver Statewide Uniform Rate Sched |
| ColoradoAny qualified provider (rate does not vary by provider) · Colorado Children's Habilitation Residential Program waiver (CHRP) | $11.87since 2023-07-01 | 15 min | $47.48 | Paid by the state, outside plans | — | CLLI, CHCBS, CHRP (effective January 1, |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Mi Via self-directed 1915(c) Waiver (NM.0448) | $11.15since 2024-10-01 | 15 min | $44.60 | Paid by the state, outside plans | — | Mi Via Waiver Fee Schedule - October 1, |
| IowaAny qualified provider (rate does not vary by provider) · Iowa HCBS Children's Mental Health (CMH) 1915(c) waiver | $10.43since 2025-08-01 | 15 min | $41.72 | Not classified | — | HCBS Habilitation and Waiver Upper Rate |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey DDD Supports Program (SP) for adults with IDD living with family or independently | $9.77since 2026-01-01 | 15 min | $39.08 | Paid by the state, outside plans | — | Quick Guide - FY26 DSP & Supervisor Rate |
| TexasAgency provider | $6.15since 2021-04-01 | 15 min | $24.60 | Paid by the state, outside plans | — | HHSC PFD YES payment rates (2021-yes-rat |
| AlabamaPhysician or licensed psychologist (incl. BCBA-D) · Alabama Community Waiver Program (1115 demonstration with 1915(c)/1915(i) services; ADMH-DDD) | $2.25since 2020-12-17 | 15 min | — | Not classified | — | ADMH Community Waiver Program Rate Sheet |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $1.57since 2022-07-01 | 15 min | $6.28 | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
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 H2021?
It depends on the state. Of the 14 states with a published fee-for-service rate, the median is $12.50. California pays the most ($213.21 per 15 min) and Pennsylvania the least ($1.57 per 15 min).
Which state pays the highest Medicaid rate for H2021?
California, at $213.21 per 15 min ($852.84 per hour), effective 2026-07-01.
Do managed-care plans pay the same rate for H2021?
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.