T1015 Medicaid reimbursement rates by state
Clinic visit/encounter, all-inclusive. 15 state Medicaid programs publish a fee-for-service rate for T1015 at the independent level. Rates run from $6.12 in Virginia to $826.00 in Texas, with a median of $71.50.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 15
- Median rate
- $71.50units vary by state
- Highest
- $826.00Texas
- Medicare (non-facility)
- —not on the physician fee schedule
T1015 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 |
|---|---|---|---|---|---|---|
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $826.00⚠ over 3× mediansince 2026-01-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - India |
| NevadaDietitian / nutritionist · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $439.86⚠ over 3× mediansince 2023-10-01 | — | — | Plans must pay at least this | — | Provider Type 15 Registered Dietitian Re |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $230.00⚠ over 3× mediansince 2026-07-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $228.66⚠ over 3× mediansince 2025-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $179.45since 2011-04-08 | — | — | Not classified | — | SCDHHS Base Physician Fee Schedule (sche |
| North DakotaAny qualified provider (rate does not vary by provider) · North Dakota Medicaid (fee-for-service) | $129.05since 2026-07-01 | — | — | Not classified | — | ND Medicaid Professional (General) Servi |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Developmental Disabilities 1915(c) Waiver (NM.0173) | $122.47since 2026-07-01 | visit | — | Paid by the state, outside plans | — | Developmental Disabilities Waiver Fee Sc |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal Expanded Access to Primary Care (EAPC, fee-for-service) | $71.50since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $41.84since 2004-04-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $40.60since 2019-07-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Practitioner |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $30.07since 2024-07-01 | — | — | Plans negotiate; applies out of network | — | Rates for Early Intervention Program Ser |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $25.30since 2025-06-04 | — | — | Not classified | — | Arkansas Medicaid Certified Nurse-Midwif |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $20.88since 2008-10-01 | — | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $10.09since 2026-01-01 | one time | — | Plans negotiate; applies out of network | — | Community Behavioral Health Services Fee |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $6.12since 2024-01-01 | — | — | Plans must pay at least this | — | DMAS procedure fee file hcpcmedical.csv |
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 T1015?
It depends on the state. Of the 15 states with a published fee-for-service rate, the median is $71.50. Texas pays the most ($826.00) and Virginia the least ($6.12).
Which state pays the highest Medicaid rate for T1015?
Texas, at $826.00, effective 2026-01-01.
Do managed-care plans pay the same rate for T1015?
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.