T2038 Medicaid reimbursement rates by state
Community transition, waiver; per service. 11 state Medicaid programs publish a fee-for-service rate for T2038 at the agency level. Rates run from $8.42 in Colorado to $5,000.00 in Virginia, with a median of $2,420.00.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 11
- Median rate
- $2,420.00units vary by state
- Highest
- $5,000.00Virginia
- Medicare (non-facility)
- —not on the physician fee schedule
T2038 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 |
|---|---|---|---|---|---|---|
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $5,000.00since 2008-07-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $4,500.00since 2025-07-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Practitioner |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana New Opportunities Waiver (NOW, OCDD/OIDD 1915(c) waiver for people with intellectual/developmental disabilities) | $3,000.00since 2025-11-18 | — | — | Paid by the state, outside plans | — | New Opportunities Waiver rate and proced |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $2,500.00since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Money Follows the Person (CIH track) | $2,500.00since 2020-07-16 | unit | — | Paid by the state, outside plans | — | IHCP Professional Fee Schedule (Last Upd |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Supports for Community Living (SCL) 1915(c) waiver | $2,420.00since 2025-01-01 | Per Transition | — | Paid by the state, outside plans | — | DMS Home and Community Based Services Wa |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Home Care Waiver (ODM) | $2,000.00since 2026-04-17 | Per job; $2,000 per waiver enrollment | — | Plans negotiate; applies out of network | — | OAC 5160-46-06 (Register of Ohio final f |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Brain Injury (BI) waiver | $1,500.00since 2026-01-01 | Decremental | — | Paid by the state, outside plans | — | Long-Term Services and Supports Service |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $1,004.00since 2025-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| TexasAgency provider · Texas Home and Community-Based Services - Adult Mental Health (HCBS-AMH, 1915(i)) | $158.28since 2025-09-01 | one time | — | Not classified | — | HHSC PFD HCBS-AMH payment rates (9-1-202 |
| ColoradoAny qualified provider (rate does not vary by provider) · Colorado HCBS waiver for persons with developmental disabilities (DD) | $8.42since 2025-10-01 | 15 min | $33.68 | Paid by the state, outside plans | — | DD, SLS, CES (effective October 1, 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 T2038?
It depends on the state. Of the 11 states with a published fee-for-service rate, the median is $2,420.00. Virginia pays the most ($5,000.00) and Colorado the least ($8.42 per 15 min).
Which state pays the highest Medicaid rate for T2038?
Virginia, at $5,000.00, effective 2008-07-01.
Do managed-care plans pay the same rate for T2038?
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.