T2043 Medicaid reimbursement rates by state
Hospice continuous home care; per hour. 8 state Medicaid programs publish a fee-for-service rate for T2043. Rates run from $51.40 in South Carolina to $1,810.61 in New Jersey, with a median of $68.10.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 8
- Median rate
- $68.10units vary by state
- Highest
- $1,810.61New Jersey
- Medicare (non-facility)
- —not on the physician fee schedule
T2043 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 |
|---|---|---|---|---|---|---|
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $1,810.61since 2025-10-01 | — | — | Not classified | — | NJ DMAHS Hospice Rates effective 2025-10 |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service) | $73.44since 2026-10-01 | hour | $73.44 | Plans negotiate; applies out of network | — | RI Medicaid Interactive Fee For Service |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $70.00since 2025-10-01 | hour | $70.00 | Plans negotiate; applies out of network | — | Rates for Hospice Services (effective Oc |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $69.37since 2026-10-01 | hour | $69.37 | Plans negotiate; applies out of network | — | Utah Medicaid Hospice Rates (October 1, |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $66.83since 2025-10-01 | hour | $66.83 | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Hospice |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $65.09since 2025-10-01 | hour | $65.09 | Not classified | — | MaineCare Section 43 Hospice rates/fee s |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid (KMAP fee-for-service schedule) | $60.00since 2025-10-01 | hour | $60.00 | Plans must pay at least this | — | KMAP Hospice FFS Provider Manual (posted |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $51.40since 2019-10-01 | per 15 min. units | — | 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 T2043?
It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $68.10. New Jersey pays the most ($1,810.61) and South Carolina the least ($51.40 per per 15 min. units).
Which state pays the highest Medicaid rate for T2043?
New Jersey, at $1,810.61, effective 2025-10-01.
Do managed-care plans pay the same rate for T2043?
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.