T1000 Medicaid reimbursement rates by state
Private duty / independent nursing service(s) - licensed. 12 state Medicaid programs publish a fee-for-service rate for T1000 at the rn level. Rates run from $8.01 in Missouri to $140.80 in South Carolina, with a median of $15.99.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 12
- Median rate
- $15.99units vary by state
- Highest
- $140.80South Carolina
- Medicare (non-facility)
- —not on the physician fee schedule
T1000 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 |
|---|---|---|---|---|---|---|
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $140.80⚠ over 3× mediansince 2017-07-01 | 15 min | $563.20 | Not classified | — | SCDHHS Physician Assistant/Nurse Practit |
| IllinoisRegistered nurse (RN) · Illinois Persons with Brain Injury waiver (DHS-DRS Home Services Program, IL.0329) | $36.75since 2026-07-01 | hour | $36.75 | Plans must pay at least this | — | HSP Rates and Fees (Medicaid Waiver Serv |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $20.05since 2025-07-01 | 15 min | $80.20 | Plans must pay at least this | — | DMAS procedure fee file hcpcmedical.csv |
| MichiganRegistered nurse (RN) · Michigan Medicaid (fee-for-service) | $18.08since 2024-10-01 | 15 min | $72.32 | Paid by the state, outside plans | — | MDHHS Private Duty Nursing Reimbursement |
| OhioRegistered nurse (RN) · Ohio Medicaid (fee-for-service) | $17.25since 2024-01-01 | 15 min | $69.00 | Plans negotiate; applies out of network | — | OAC 5160-12-06 Appendix A (ODM private d |
| WashingtonRegistered nurse (RN) · Washington Apple Health (Medicaid) fee-for-service | $16.97since 2025-01-01 | 15 min | $67.88 | Plans must pay at least this | — | HCA Private duty nursing fee schedule (p |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $15.00since 2024-01-01 | 15 min | $60.00 | Plans negotiate; applies out of network | — | KY Medicaid PDN fee schedule (2024-Priva |
| 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 |
| NebraskaRegistered nurse (RN) · Nebraska Medicaid (fee-for-service) | $11.23since 2026-07-01 | unit | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| TexasRegistered nurse (RN) · Texas Medicaid (fee-for-service, TMHP) | $10.22since 2023-09-01 | 15 min | $40.88 | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Thste |
| FloridaRegistered nurse (RN) · Florida iBudget waiver for people with developmental disabilities (APD) | $8.16since 2026-07-01 | 15 min | $32.64 | Paid by the state, outside plans | — | Florida Medicaid Developmental Disabilit |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $8.01since 2016-07-08 | 15 min | $32.04 | Plans must pay at least this | — | MO HealthNet fee schedule: Practitioner |
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 T1000?
It depends on the state. Of the 12 states with a published fee-for-service rate, the median is $15.99. South Carolina pays the most ($140.80 per 15 min) and Missouri the least ($8.01 per 15 min).
Which state pays the highest Medicaid rate for T1000?
South Carolina, at $140.80 per 15 min ($563.20 per hour), effective 2017-07-01.
Do managed-care plans pay the same rate for T1000?
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.