H2026 Medicaid reimbursement rates by state
Ongoing support to maintain employment, per diem. 7 state Medicaid programs publish a fee-for-service rate for H2026 at the clinical nurse specialist level. Rates run from $28.06 in Texas to $620.00 in Utah, with a median of $207.65.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 7
- Median rate
- $207.65units vary by state
- Highest
- $620.00Utah
- Medicare (non-facility)
- —not on the physician fee schedule
H2026 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 |
|---|---|---|---|---|---|---|
| UtahAny qualified provider (rate does not vary by provider) · Utah Acquired Brain Injury 1915(c) waiver | $620.00since 2026-10-05 | day | — | Paid by the state, outside plans | — | Utah Medicaid Coverage and Reimbursement |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Public Behavioral Health System (specialty mental health, SUD and ABA, paid fee-for-service through the Carelon ASO) | $554.35since 2024-07-01 | month | — | Paid by the state, outside plans | — | FY2025 PBHS Fee Schedule – PRP and Speci |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma ODMHSAS state-funded behavioral health services (non-Medicaid 'State Rate') | $420.00since 2015-03-01 | unit | — | Not classified | — | ODMHSAS PICIS 'Rates and Codes for Agenc |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS behavioral health outpatient MCO capped fee schedule | $207.65since 2026-10-01 | — | — | Suggested schedule for plans | — | AHCCCS MCO Fee Schedule Final MCO Behavi |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana New Opportunities Waiver (NOW, OCDD/OIDD 1915(c) waiver for people with intellectual/developmental disabilities) | $70.00since 2025-11-18 | day | — | Paid by the state, outside plans | — | New Opportunities Waiver rate and proced |
| 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 |
| TexasAgency provider · Texas Community Living Assistance and Support Services (CLASS) waiver | $28.06since 2025-09-01 | hour | $28.06 | Paid by the state, outside plans | — | HHSC PFD CLASS payment rates (9-1-2025-c |
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 H2026?
It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $207.65. Utah pays the most ($620.00 per day) and Texas the least ($28.06 per hour).
Which state pays the highest Medicaid rate for H2026?
Utah, at $620.00 per day, effective 2026-10-05.
Do managed-care plans pay the same rate for H2026?
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.