S0280 Medicaid reimbursement rates by state
Medical home program. 8 state Medicaid programs publish a fee-for-service rate for S0280 at the physician psychologist level. Rates run from $50.00 in North Carolina to $456.44 in Nevada, with a median of $300.00.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 8
- Median rate
- $300.00units vary by state
- Highest
- $456.44Nevada
- Medicare (non-facility)
- —not on the physician fee schedule
S0280 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 |
|---|---|---|---|---|---|---|
| NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $456.44since 2025-10-01 | — | — | Plans must pay at least this | — | Provider Type 85 Applied Behavioral Anal |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $380.56since 2023-07-01 | — | — | Plans must pay at least this | — | DMAS procedure fee file hcpcmedical.csv |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $359.37since 2012-10-01 | — | — | Paid by the state, outside plans | — | ForwardHealth interactive max fee schedu |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $350.00since 2026-05-21 | One payment per month | — | State sets the plan rate | — | MH Procedure CPT or HCPC Codes and Rates |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid community palliative care benefit (QI / CCS / FFS) | $250.00since 2025-01-01 | $250 (maximum of | — | Not classified | — | Med-QUEST memo QI-2430A |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $102.67since 2026-07-01 | — | — | Not classified | — | South Dakota Medicaid Physician fee sche |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $100.00since 2026-06-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $50.00since 2022-01-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Nurse Practiti |
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 S0280?
It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $300.00. Nevada pays the most ($456.44) and North Carolina the least ($50.00).
Which state pays the highest Medicaid rate for S0280?
Nevada, at $456.44, effective 2025-10-01.
Do managed-care plans pay the same rate for S0280?
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.