T1001 Medicaid reimbursement rates by state
Nursing assessment / evaluation. 14 state Medicaid programs publish a fee-for-service rate for T1001 at the rn level. Rates run from $8.16 in Florida to $176.00 in South Carolina, with a median of $73.27.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 14
- Median rate
- $73.27units vary by state
- Highest
- $176.00South Carolina
- Medicare (non-facility)
- —not on the physician fee schedule
T1001 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 CarolinaRegistered nurse (RN) · South Carolina Healthy Connections Medicaid (fee-for-service) | $176.00since 2016-01-01 | — | — | Plans negotiate; applies out of network | — | SCDHHS Nurse Midwives Fee Schedule (sche |
| PennsylvaniaRegistered nurse (RN) · Pennsylvania Medical Assistance (fee-for-service) | $175.00since 2005-10-01 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| CaliforniaRegistered nurse (RN) · California Medi-Cal Specialty Mental Health Services (DHCS fee schedule for county Mental Health Plans) | $169.24since 2026-07-01 | — | — | Paid by the state, outside plans | — | Medi-Cal Behavioral Health Fee Schedules |
| MarylandRegistered nurse (RN) · Maryland Medicaid (fee-for-service, MDH) | $150.00since 2024-07-01 | — | — | Not classified | — | PT 07-25 Fiscal Year 2025 Rates for Nurs |
| MinnesotaRegistered nurse (RN) · Minnesota Medical Assistance home care (state plan: home health, PCA/CFSS, home care nursing) | $138.32since 2026-01-01 | visit | — | Plans must pay at least this | — | Long-Term Services and Supports Service |
| North CarolinaRegistered nurse (RN) · North Carolina Medicaid Direct (fee-for-service) | $87.09since 2026-07-01 | — | — | Paid by the state, outside plans | — | NC Medicaid fee schedule 'Local Educatio |
| WisconsinRegistered nurse (RN) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $85.54since 2008-07-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| MissouriRegistered nurse (RN) · Missouri MO HealthNet (fee-for-service) | $60.99since 2023-07-01 | — | — | Plans negotiate; applies out of network | — | MO HealthNet fee schedule: Personal Care |
| New JerseyRegistered nurse (RN) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $51.00since 2025-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| VirginiaRegistered nurse (RN) · Virginia Medicaid (fee-for-service, DMAS) | $33.48since 2025-07-01 | — | — | Paid by the state, outside plans | — | DMAS procedure fee file hcpcmedical.csv |
| WashingtonRegistered nurse (RN) · Washington ALTSA nursing services (nurse delegation, private duty nursing for adults) | $33.00since 2019-07-01 | EA | — | Paid by the state, outside plans | — | DSHS ORM Home & Community Based Rates Hi |
| LouisianaRegistered nurse (RN) · Louisiana Medicaid (fee-for-service) | $15.18since 2013-02-20 | — | — | Plans must pay at least this | — | Louisiana Medicaid Office of Public Heal |
| OhioRegistered nurse (RN) · Ohio Medicaid (fee-for-service) | $10.53since 2021-11-01 | 15 min | $42.12 | Plans negotiate; applies out of network | — | OAC 5160-12-08 Appendix A (ODM RN assess |
| 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 |
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 T1001?
It depends on the state. Of the 14 states with a published fee-for-service rate, the median is $73.27. South Carolina pays the most ($176.00) and Florida the least ($8.16 per 15 min).
Which state pays the highest Medicaid rate for T1001?
South Carolina, at $176.00, effective 2016-01-01.
Do managed-care plans pay the same rate for T1001?
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.