T1004 Medicaid reimbursement rates by state
Services of a qualified nursing aide, up to 15 minutes. 9 state Medicaid programs publish a fee-for-service rate for T1004 at the aide level. Rates run from $0.80 in Florida to $30.25 in Kentucky, with a median of $8.66.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 9
- Median rate
- $8.66units vary by state
- Highest
- $30.25Kentucky
- Medicare (non-facility)
- —not on the physician fee schedule
T1004 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 |
|---|---|---|---|---|---|---|
| KentuckyAide or attendant (HHA, CNA, PCA, home care aide) · Kentucky Acquired Brain Injury Long Term Care 1915(c) waiver | $30.25⚠ over 3× mediansince 2025-01-01 | 15 min | $121.00 | Paid by the state, outside plans | — | DMS Home and Community Based Services Wa |
| New JerseyAide or attendant (HHA, CNA, PCA, home care aide) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $25.76since 2025-01-01 | 15 min | $103.04 | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| IllinoisAide or attendant (HHA, CNA, PCA, home care aide) · Illinois Medically Fragile, Technology Dependent waiver (IL.0278) and EPSDT in-home nursing, operated by UIC-DSCC | $25.68since 2025-01-01 | Client Hour | — | Not classified | — | Medically Fragile Technology Dependent ( |
| MassachusettsAide or attendant (HHA, CNA, PCA, home care aide) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $11.25since 2024-08-01 | 15 min | $45.00 | Paid by the state, outside plans | — | Rates for Continuous Skilled Nursing Age |
| North CarolinaAide or attendant (HHA, CNA, PCA, home care aide) · North Carolina CAP consumer-directed option (CAP/CD) | $8.66since 2026-08-01 | 15 min | $34.64 | Paid by the state, outside plans | — | NC Medicaid fee schedule 'CAP- Consumer |
| MinnesotaAide or attendant (HHA, CNA, PCA, home care aide) · Minnesota Brain Injury (BI) waiver | $7.70since 2026-01-01 | 15 min | $30.80 | Paid by the state, outside plans | — | Long-Term Services and Supports Service |
| CaliforniaAide or attendant (HHA, CNA, PCA, home care aide) · California Medi-Cal school-based services (Local Educational Agency) | $5.31since 2026-10-01 | 15 min | $21.24 | Paid by the state, outside plans | — | Medi-Cal Rates (Rates files zip: rates_d |
| MarylandAide or attendant (HHA, CNA, PCA, home care aide) · Maryland Medicaid (fee-for-service, MDH) | $3.90since 2024-07-01 | 15 min | $15.59 | Not classified | — | PT 07-25 Fiscal Year 2025 Rates for Nurs |
| FloridaAide or attendant (HHA, CNA, PCA, home care aide) · Florida Medicaid (fee-for-service) | $0.80since 2026-01-01 | 15 min | $3.20 | Paid by the state, outside plans | — | Medicaid Certified School Match Program |
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 T1004?
It depends on the state. Of the 9 states with a published fee-for-service rate, the median is $8.66. Kentucky pays the most ($30.25 per 15 min) and Florida the least ($0.80 per 15 min).
Which state pays the highest Medicaid rate for T1004?
Kentucky, at $30.25 per 15 min ($121.00 per hour), effective 2025-01-01.
Do managed-care plans pay the same rate for T1004?
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.