T1016 Medicaid reimbursement rates by state
Case management, each 15 minutes. 32 state Medicaid programs publish a fee-for-service rate for T1016 at the case manager level. Rates run from $4.25 in Arkansas to $425.92 in Kentucky, with a median of $19.42.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 32
- Median rate
- $19.42units vary by state
- Highest
- $425.92Kentucky
- Medicare (non-facility)
- —not on the physician fee schedule
T1016 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 |
|---|---|---|---|---|---|---|
| KentuckyCase manager / support coordinator · Kentucky Home and Community Based (HCB) 1915(c) waiver | $425.92since 2025-01-01 | month | — | Paid by the state, outside plans | — | DMS Home and Community Based Services Wa |
| New HampshireCase manager / support coordinator · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $425.34⚠ over 3× mediansince 2023-07-01 | 15 min | $1,701.36 | Plans must pay at least this | — | 2026 Fee Schedule - Covered Procedures R |
| VirginiaCase manager / support coordinator · Virginia Medicaid (fee-for-service, DMAS) | $367.31⚠ over 3× mediansince 2021-07-01 | 15 min | $1,469.24 | Plans must pay at least this | — | DMAS procedure fee file hcpcmedical.csv |
| HawaiiCase manager / support coordinator · Hawaii Medicaid (Med-QUEST) fee-for-service | $336.00⚠ over 3× mediansince 2024-03-04 | 15 min | $1,344.00 | Plans negotiate; applies out of network | — | Medicaid Fee-For-Service (FFS) Fee Sched |
| MarylandCase manager / support coordinator · Maryland Public Behavioral Health System (specialty mental health, SUD and ABA, paid fee-for-service through the Carelon ASO) | $172.13since 2024-07-01 | day | — | Paid by the state, outside plans | — | FY2025 PBHS Fee Schedule – PRP and Speci |
| IowaCase manager / support coordinator · Iowa HCBS Brain Injury (BI) 1915(c) waiver | $72.59⚠ over 3× mediansince 2025-08-01 | 15 min | $290.36 | Not classified | — | HCBS Habilitation and Waiver Upper Rate |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $54.24since 2025-01-01 | 15 min | $216.96 | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| OregonCase manager / support coordinator · Oregon Health Plan (fee-for-service, OHA) | $34.49since 2024-07-01 | 15 min | $137.96 | Plans negotiate; applies out of network | — | OHP FFS behavioral health fee schedule ( |
| IllinoisCase manager / support coordinator · Illinois Medicaid (HFS fee-for-service) | $33.32since 2022-07-01 | 1/4 hr | — | Plans negotiate; applies out of network | — | HFS Community Based Behavioral Services |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Specialized Recovery Services (1915(i) for adults with serious mental illness) | $27.54since 2025-08-22 | unit | — | Plans expected to pay at least this | — | Specialized Recovery Services Program Ra |
| MississippiCase manager / support coordinator · Mississippi HCBS Elderly and Disabled (E&D) 1915(c) waiver (incl. Community Transition Services) | $26.83since 2023-07-01 | 15 min | $107.32 | Paid by the state, outside plans | — | MS DOM Elderly and Disabled Waiver fee s |
| MinnesotaCase manager / support coordinator · Minnesota Alternative Care (AC, state-funded program for people 65+) | $25.46since 2026-01-01 | 15 min | $101.84 | Not classified | — | Long-Term Services and Supports Service |
| Rhode IslandCase manager / support coordinator · Rhode Island Medicaid (fee-for-service) | $23.90since 2026-10-01 | 15 min | $95.60 | Plans negotiate; applies out of network | — | RI Medicaid Interactive Fee For Service |
| OklahomaCase manager / support coordinator · Oklahoma ADvantage 1915(c) waiver (older adults and adults with physical disabilities) | $21.02since 2024-10-01 | 15 min | $84.08 | Paid by the state, outside plans | — | Reimbursement Rates for Services, ADvant |
| MaineCase manager / support coordinator · MaineCare Home and Community Based Services for Adults with Brain Injury (MBM Section 18 waiver, fee-for-service) | $20.39since 2026-01-01 | 15 min | $81.56 | Not classified | — | MaineCare Section 18 Brain Injury Waiver |
| ArizonaCase manager / support coordinator · Arizona AHCCCS behavioral health outpatient MCO capped fee schedule | $19.93since 2026-10-01 | 15 min | $79.72 | Suggested schedule for plans | — | AHCCCS MCO Fee Schedule Final MCO Behavi |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Intellectual Disability and Related Disabilities (ID/RD) Waiver (SC.0237, DDSN-operated) | $18.90since 2025-11-01 | 15 min | $75.60 | Paid by the state, outside plans | — | SCDHHS HCBS Waivers Fee Schedule (Effect |
| UtahCase manager / support coordinator · Utah Medicaid (fee-for-service, Traditional plan) | $18.11since 2006-04-01 | 15 min | $72.44 | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| North CarolinaCase manager / support coordinator · North Carolina Medicaid Direct (fee-for-service) | $17.52since 2025-10-01 | 15 min | $70.08 | Plans must pay at least this | — | NC Medicaid fee schedule 'Local Health D |
| MontanaCase manager / support coordinator · Montana Medicaid and HMK Plus (fee-for-service) | $17.01since 2025-07-01 | 15 min. | — | Not classified | — | Medicaid Behavioral Health Targeted Case |
| NevadaCase manager / support coordinator · Nevada HCBS Waiver for the Frail Elderly (provider types 48, 57 and 59, fee-for-service) | $15.84since 2023-01-01 | 15 min | $63.36 | Paid by the state, outside plans | — | Provider Type 48 Home and Community Base |
| IndianaCase manager / support coordinator · Indiana Medicaid Rehabilitation Option (MRO) community mental health services | $14.53since 2010-07-01 | 15 min | $58.12 | Paid by the state, outside plans | — | IHCP Professional Fee Schedule (Last Upd |
| GeorgiaCase manager / support coordinator · Georgia Independent Care Waiver Program (adults with physical disabilities or brain injury) | $14.45since 2024-07-01 | per unit | — | Paid by the state, outside plans | — | Part II Policies and Procedures: Indepen |
| ConnecticutCase manager / support coordinator · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $13.76since 2026-01-01 | 15 min | $55.04 | Not classified | — | CMAP fee schedule: Physician Office and |
| CaliforniaCase manager / support coordinator · California Medi-Cal (fee-for-service) | $13.41since 2026-10-01 | 15 min | $53.64 | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| VermontCase manager / support coordinator · Vermont Medicaid (fee-for-service, DVHA) | $12.50since 2004-02-01 | 15 min | $50.00 | Not classified | — | Vermont Medicaid Fee Schedule - HCPCS (i |
| ColoradoCase manager / support coordinator · Colorado Children's Home and Community-Based Services waiver (CHCBS) | $9.73since 2023-07-01 | 15 min | $38.92 | Paid by the state, outside plans | — | CLLI, CHCBS, CHRP (effective January 1, |
| West VirginiaCase manager / support coordinator · West Virginia Aged and Disabled 1915(c) Waiver (ADW) | $8.50since 2026-04-01 | 15 min | $34.00 | Paid by the state, outside plans | — | ADW Rate Chart (Aged and Disabled Rate C |
| MissouriCase manager / support coordinator · Missouri MO HealthNet (fee-for-service) | $5.35since 2019-07-01 | each 15 minutes | — | Plans must pay at least this | — | MO HealthNet fee schedule: Practitioner |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $4.78since 2022-01-01 | 15 min | $19.12 | Paid by the state, outside plans | — | ForwardHealth max fee schedule: HlthCk-C |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $4.59since 2026-07-01 | 15 min | $18.36 | Plans negotiate; applies out of network | — | HCA Physician-related services fee sched |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $4.25since 2016-04-27 | 15 min | $17.00 | Not classified | — | Arkansas Medicaid Targeted Case Manageme |
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 T1016?
It depends on the state. Of the 32 states with a published fee-for-service rate, the median is $19.42. Kentucky pays the most ($425.92 per month) and Arkansas the least ($4.25 per 15 min).
Which state pays the highest Medicaid rate for T1016?
Kentucky, at $425.92 per month, effective 2025-01-01.
Do managed-care plans pay the same rate for T1016?
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.
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Track T1016 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.