M0232 Medicaid reimbursement rates by state
Intravenous infusion, tocilizumabbavi. 5 state Medicaid programs publish a fee-for-service rate for M0232 at the therapist ot level. Rates run from $72.95 in Texas to $2,220.00 in New Hampshire, with a median of $427.50.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 5
- Median rate
- $427.50units vary by state
- Highest
- $2,220.00New Hampshire
- Medicare (non-facility)
- —not on the physician fee schedule
M0232 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 |
|---|---|---|---|---|---|---|
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $2,220.00⚠ over 3× mediansince 2026-07-01 | — | — | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $450.50since 2026-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, Septembe |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $427.50since 2026-07-01 | — | — | Not classified | — | Vermont Medicaid Fee Schedule - HCPCS (i |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $348.61since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| TexasOccupational therapist · Texas Home Living (TxHmL) waiver (IDD) | $72.95since 2024-09-01 | hour | $72.95 | Paid by the state, outside plans | — | HHSC PFD TxHmL payment rates (09-2024-tx |
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 M0232?
It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $427.50. New Hampshire pays the most ($2,220.00) and Texas the least ($72.95 per hour).
Which state pays the highest Medicaid rate for M0232?
New Hampshire, at $2,220.00, effective 2026-07-01.
Do managed-care plans pay the same rate for M0232?
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.