T2042 Medicaid reimbursement rates by state
Hospice routine home care; per diem. 8 state Medicaid programs publish a fee-for-service rate for T2042. Rates run from $135.99 in South Carolina to $231.13 in Massachusetts, with a median of $210.95.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 8
- Median rate
- $210.95per day
- Highest
- $231.13Massachusetts
- Medicare (non-facility)
- —not on the physician fee schedule
T2042 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 |
|---|---|---|---|---|---|---|
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $231.13since 2025-10-01 | day | — | Plans negotiate; applies out of network | — | Rates for Hospice Services (effective Oc |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $223.84since 2025-10-01 | day | — | Not classified | — | MaineCare Section 43 Hospice rates/fee s |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service) | $222.38since 2026-10-01 | day | — | Plans negotiate; applies out of network | — | Hospice provider directory page: Tier 1 |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $219.21since 2025-10-01 | day | — | Not classified | — | NJ DMAHS Hospice Rates effective 2025-10 |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid (KMAP fee-for-service schedule) | $202.68since 2025-10-01 | day | — | Plans must pay at least this | — | KMAP Hospice FFS Provider Manual (posted |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $192.39since 2025-10-01 | day | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Hospice |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $183.64since 2026-10-01 | day | — | Plans negotiate; applies out of network | — | Utah Medicaid Hospice Rates (October 1, |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $135.99since 2019-10-01 | day | — | Paid by the state, outside plans | — | SCDHHS Medicaid Hospice Rates FFY2020 |
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 T2042?
It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $210.95 per day. Massachusetts pays the most ($231.13 per day) and South Carolina the least ($135.99 per day).
Which state pays the highest Medicaid rate for T2042?
Massachusetts, at $231.13 per day, effective 2025-10-01.
Do managed-care plans pay the same rate for T2042?
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.