S9123 Medicaid reimbursement rates by state
Nursing care, in the home; by registered nurse, per hour. 30 state Medicaid programs publish a fee-for-service rate for S9123 at the rn level. Rates run from $13.00 in North Carolina to $254.03 in Utah, with a median of $45.65.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 30
- Median rate
- $45.65units vary by state
- Highest
- $254.03Utah
- Medicare (non-facility)
- —not on the physician fee schedule
S9123 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 |
|---|---|---|---|---|---|---|
| UtahRegistered nurse (RN) · Utah Medicaid (fee-for-service, Traditional plan) | $254.03⚠ over 3× mediansince 2026-07-01 | hour | $254.03 | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| IowaRegistered nurse (RN) · Iowa HCBS Intellectual Disability (ID) 1915(c) waiver | $98.87since 2025-08-01 | hour | $98.87 | Not classified | — | HCBS Habilitation and Waiver Upper Rate |
| OregonRegistered nurse (RN) · Oregon Health Plan (fee-for-service, OHA) | $94.53since 2023-07-01 | hour | $94.53 | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| South DakotaRegistered nurse (RN) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $92.80since 2026-07-01 | hour | $92.80 | Not classified | — | South Dakota Medicaid PDN fee schedule ( |
| ColoradoRegistered nurse (RN) · Colorado HCBS waiver for children with complex health needs (CwCHN) | $83.43since 2026-07-01 | hour | $83.43 | Paid by the state, outside plans | — | CwCHN, CHRP (effective July 1, 2026) |
| New HampshireRegistered nurse (RN) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $75.84since 2024-01-01 | hour | $75.84 | Plans must pay at least this | — | 2026 Fee Schedule - Covered Procedures R |
| LouisianaRegistered nurse (RN) · Louisiana Medicaid (fee-for-service) | $65.46since 2023-04-03 | hour | $65.46 | Plans must pay at least this | — | Louisiana Medicaid Home Health Services |
| ArizonaRegistered nurse (RN) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $64.22since 2026-10-01 | hour | $64.22 | Plans expected to pay at least this | — | AHCCCS Final FFS Home and Community Base |
| NevadaRegistered nurse (RN) · Nevada HCBS Waiver for Individuals with Intellectual and Developmental Disabilities (provider type 38, fee-for-service) | $64.00since 2023-07-01 | hour | $64.00 | Paid by the state, outside plans | — | Provider Type 38, Waiver for Individuals |
| DelawareRegistered nurse (RN) · Delaware Medicaid (fee-for-service, DMMA / DMAP) | $63.67since 2024-01-01 | hour | $63.67 | Plans negotiate; applies out of network | — | DMAP 2024 Physician Fee Schedule |
| South CarolinaRegistered nurse (RN) · South Carolina Healthy Connections Medicaid (fee-for-service) | $63.42since 2026-10-01 | hour | — | Paid by the state, outside plans | — | SCDHHS Medicaid Hospice Rates FFY2027 |
| MinnesotaRegistered nurse (RN) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $61.73since 2004-04-01 | hour | $61.73 | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| PennsylvaniaRegistered nurse (RN) · Pennsylvania Medical Assistance (fee-for-service) | $50.00since 2005-10-01 | hour | $50.00 | State-directed payment | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| ConnecticutRegistered nurse (RN) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $49.27since 2021-07-01 | hour | $49.27 | Not classified | — | CMAP fee schedule: Home Health Services |
| CaliforniaRegistered nurse (RN) · California Medi-Cal (fee-for-service) | $47.91since 2026-10-01 | hour | $47.91 | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| TexasRegistered nurse (RN) · Texas Home and Community-Based Services - Adult Mental Health (HCBS-AMH, 1915(i)) | $43.39since 2025-09-01 | hour | $43.39 | Not classified | — | HHSC PFD HCBS-AMH payment rates (9-1-202 |
| NebraskaRegistered nurse (RN) · Nebraska Medicaid (fee-for-service) | $40.75since 2026-07-01 | hour | $40.75 | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| WisconsinRegistered nurse (RN) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $37.76since 2022-01-01 | hour | $37.76 | Plans may pay no more | — | ForwardHealth max fee schedule: Home Car |
| AlabamaRegistered nurse (RN) · Alabama Community Waiver Program (1115 demonstration with 1915(c)/1915(i) services; ADMH-DDD) | $36.40since 2020-12-17 | hour | — | Not classified | — | ADMH Community Waiver Program Rate Sheet |
| New YorkRegistered nurse (RN) · New York Medicaid (fee-for-service) | $31.21since 2022-04-01 | hour | $31.21 | Plans negotiate; applies out of network | — | eMedNY NYS Medicaid Private Duty Nursing |
| MississippiRegistered nurse (RN) · Mississippi Medicaid (fee-for-service) | $29.33since 2022-10-01 | hour | $29.33 | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, June 202 |
| ArkansasRegistered nurse (RN) · Arkansas Medicaid (fee-for-service) | $28.00since 2025-06-04 | hour | $28.00 | Not classified | — | Arkansas Medicaid Private Duty Nursing F |
| KansasRegistered nurse (RN) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $26.00since 2002-07-01 | hour | $26.00 | Paid by the state, outside plans | — | KMAP Fee Schedule MKN LEA (FeeSchedule_2 |
| VirginiaRegistered nurse (RN) · Virginia Medicaid (fee-for-service, DMAS) | $25.86since 2026-07-01 | hour | $25.86 | Paid by the state, outside plans | — | DMAS procedure fee file hcpcmedical.csv |
| GeorgiaRegistered nurse (RN) · Georgia Independent Care Waiver Program (adults with physical disabilities or brain injury) | $23.84since 2024-07-01 | 15 min | $95.36 | Paid by the state, outside plans | — | Part II Policies and Procedures: Indepen |
| HawaiiRegistered nurse (RN) · Hawaii Med-QUEST HCBS fee-for-service rates (QI memos) | $23.51since 2026-01-01 | 15 min | $94.04 | Plans negotiate; applies out of network | — | Med-QUEST memo QI-2604A: 2026 |
| MontanaRegistered nurse (RN) · Montana Big Sky Waiver for elderly and physically disabled adults (1915(c), fee-for-service) | $21.86since 2025-07-01 | 15 min | $87.44 | Not classified | — | Montana Healthcare Programs fee schedule |
| FloridaRegistered nurse (RN) · Florida Medicaid (fee-for-service) | $16.12since 2026-01-01 | /hr | $16.12 | Plans negotiate; applies out of network | — | Private Duty Nursing Services Fee Schedu |
| New JerseyRegistered nurse (RN) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $15.75since 2025-01-01 | hour | $15.75 | Plans must pay at least this | — | NJMMIS Procedure Master Listing CPTHCPCS |
| North CarolinaRegistered nurse (RN) · North Carolina Medicaid Direct (fee-for-service) | $13.00since 2025-10-01 | 15 min. | $52.00 | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Private Duty N |
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 S9123?
It depends on the state. Of the 30 states with a published fee-for-service rate, the median is $45.65. Utah pays the most ($254.03 per hour) and North Carolina the least ($13.00 per 15 min.).
Which state pays the highest Medicaid rate for S9123?
Utah, at $254.03 per hour ($254.03 per hour), effective 2026-07-01.
Do managed-care plans pay the same rate for S9123?
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.
Related Private duty nursing codes
T1002Rn services, up to 15 minutes · 41 statesT1003Lpn/lvn services, up to 15 minutes · 35 statesT1000Private duty / independent nursing service(s) - licensed · 21 statesG2252Waiver nursing (RN or LPN, by the 15 minutes) · 17 statesT1004Services of a qualified nursing aide, up to 15 minutes · 17 statesG2251Waiver nursing (RN or LPN, by the 15 minutes) · 16 statesG2250Waiver nursing (RN or LPN, by the 15 minutes) · 14 statesS5108Home care training to home care client, per 15 minutes · 9 statesS5110Home care training, family; per 15 minutes · 7 statesS5115Home care training, non-family; per 15 minutes · 7 statesG2215Waiver nursing (RN or LPN, by the 15 minutes) · 5 states
Track S9123 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.