T2025 Medicaid reimbursement rates by state
Waiver services; not otherwise specified (nos). 10 state Medicaid programs publish a fee-for-service rate for T2025 at the self directed level. Rates run from $5.10 in Georgia to $4,000.00 in Indiana, with a median of $94.31.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 10
- Median rate
- $94.31units vary by state
- Highest
- $4,000.00Indiana
- Medicare (non-facility)
- —not on the physician fee schedule
T2025 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 |
|---|---|---|---|---|---|---|
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Health & Wellness Waiver (adults with disabilities under 60; formerly A&D) | $4,000.00since 2018-07-01 | unit | — | Paid by the state, outside plans | — | IHCP Professional Fee Schedule (Last Upd |
| FloridaAny qualified provider (rate does not vary by provider) · Florida iBudget waiver for people with developmental disabilities (APD) | $1,063.24since 2026-07-01 | day | — | Paid by the state, outside plans | — | Florida Medicaid Developmental Disabilit |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Brain Injury (BI) waiver | $500.00since 2026-01-01 | Decremental | — | Paid by the state, outside plans | — | Long-Term Services and Supports Service |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington ALTSA home and community services (other HCBS) | $150.00since 2019-07-01 | EA | — | Paid by the state, outside plans | — | DSHS ORM Home & Community Based Rates Hi |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $100.00since 2025-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| TexasAgency provider | $88.62since 2021-04-01 | day | — | Paid by the state, outside plans | — | HHSC PFD YES payment rates (2021-yes-rat |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $35.77since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania OBRA Waiver (adults with developmental physical disabilities) | $14.48since 2026-07-01 | 15 min | $57.92 | Not classified | — | OLTL Home and Community Based Waiver Ser |
| ColoradoSelf-directed worker (hired by the person or family) · Colorado HCBS waiver: Supported Living Services (SLS) | $6.71since 2025-10-01 | 15 min | $26.84 | Paid by the state, outside plans | — | DD, SLS, CES (effective October 1, 2025) |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia New Options Waiver (NOW) for people with IDD | $5.10since 2025-04-01 | 15 min | $20.40 | Paid by the state, outside plans | — | New Options Waiver Program-Q2-April 2025 |
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 T2025?
It depends on the state. Of the 10 states with a published fee-for-service rate, the median is $94.31. Indiana pays the most ($4,000.00 per unit) and Georgia the least ($5.10 per 15 min).
Which state pays the highest Medicaid rate for T2025?
Indiana, at $4,000.00 per unit, effective 2018-07-01.
Do managed-care plans pay the same rate for T2025?
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.