S9485 Medicaid reimbursement rates by state
Crisis intervention mental health services, per diem. 21 state Medicaid programs publish a fee-for-service rate for S9485 at the unlicensed practitioner level. Rates run from $142.14 in Kansas to $1,804.61 in New Mexico, with a median of $483.02.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 21
- Median rate
- $483.02units vary by state
- Highest
- $1,804.61New Mexico
- Medicare (non-facility)
- —not on the physician fee schedule
S9485 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 MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $1,804.61since 2025-01-01 | encounter | — | Plans must pay at least this | — | Fee Schedule for Behavioral Health Provi |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $1,759.04⚠ over 3× mediansince 2025-01-01 | day | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $1,555.01since 2026-07-01 | Per Unit | — | Not classified | — | MaineCare Section 66 Crisis Services rat |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $1,012.07since 2024-01-01 | day | — | Plans must pay at least this | — | DMAS procedure fee file hcpcmedical.csv |
| 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) | $742.85since 2024-07-01 | day | — | Paid by the state, outside plans | — | FY2025 PBHS Fee Schedule – BH Crisis Ser |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $695.29since 2025-08-15 | day | — | Plans must pay at least this | — | Rates for Behavioral Health Services Pro |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $642.75since 2026-01-01 | day | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $600.00since 2022-03-30 | encounter | — | Plans must pay at least this | — | Provider Type 87 Crisis Services (rate d |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $520.00since 2026-01-01 | day | — | Paid by the state, outside plans | — | ForwardHealth max fee schedule: Mntl Hlt |
| OhioUnlicensed (bachelor's/master's) behavioral health practitioner · Ohio Medicaid (fee-for-service) | $487.79since 2024-01-01 | day | — | Plans expected to pay at least this | — | OAC 5160-27-03 Appendix A, Community Beh |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $483.02since 2026-07-01 | day | — | Plans negotiate; applies out of network | — | Nebraska Medicaid Mental Health and Subs |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $466.44since 2024-01-01 | day | — | Plans negotiate; applies out of network | — | HCA Specialized mental health fee schedu |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $412.91since 2025-07-01 | day | — | Not classified | — | Medicaid Mental Health Services for Adul |
| AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $404.80since 2025-07-01 | encounter | — | Not classified | — | Rehab Option MI Fee Schedule |
| LouisianaMaster's-level staff · Louisiana Medicaid (fee-for-service) | $392.46since 2025-10-01 | day | — | Plans must pay at least this | — | Specialized Behavioral Health Services f |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS behavioral health outpatient MCO capped fee schedule | $350.51since 2026-10-01 | — | — | Suggested schedule for plans | — | AHCCCS MCO Fee Schedule Final MCO Behavi |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $230.00since 2020-01-01 | day | — | Plans negotiate; applies out of network | — | DMS CMHC Mental Health Substance Abuse f |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $209.14since 2015-04-01 | unit | — | Plans must pay at least this | — | ODMHSAS PICIS 'Rates and Codes for Agenc |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $188.83since 2024-07-01 | day | — | Not classified | — | CMAP fee schedule: Clinic and Outpatient |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $159.32since 2024-07-01 | day | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #21 COMMUNITY |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $142.14since 2017-09-15 | day | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
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 S9485?
It depends on the state. Of the 21 states with a published fee-for-service rate, the median is $483.02. New Mexico pays the most ($1,804.61 per encounter) and Kansas the least ($142.14 per day).
Which state pays the highest Medicaid rate for S9485?
New Mexico, at $1,804.61 per encounter, effective 2025-01-01.
Do managed-care plans pay the same rate for S9485?
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 Behavioral health codes
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Track S9485 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.