Behavioral health Medicaid rates in Vermont combine a current therapy rate with community rates that date to 2004. Vermont Medicaid pays $89.18 on family therapy code 90846, which ranks 8th of 28 states and sits 7.0% above the $83.33 national median, effective 2026-01-01.
Its therapeutic behavioral services, skills training and wraparound rates, by contrast, all carry an effective date of 2004-01-01, and the state's current changes run through its CCBHC demonstration, case rates and a series of 2026 rate notices rather than the fee schedule lines. Rates are compiled from official Vermont Medicaid publications, and each rate on the Vermont Medicaid rates hub links back to its source document.
| Service | Code | Vermont rate | Effective since | Rank |
|---|---|---|---|---|
| Outpatient psychotherapy and evaluation | 90846 | $89.18 | 2026-01-01 | 8 of 28 |
| Therapeutic behavioral services | H2019 | $87.76 an hour | 2004-01-01 | 15 of 28 |
| Skills training and development | H2014 | $29.96 an hour | 2004-01-01 | 25 of 33 |
| Mental health counseling | H0036 (HI) | $83.64 an hour | 2025-07-01 | not ranked |
| Community-based wraparound | H2022 | $356.79 a day | 2004-01-01 | not ranked |
These are the comparison lines. Vermont's behavioral health line holds 466 current rates, part of all 34,243 current Vermont Medicaid rates, each linked to its source publication.
The 90846 rate of $89.18 places Vermont 8th of 28. The states ahead of it include California ($302.03), New Mexico ($144.88), North Dakota ($118.28), Nebraska ($115.68) and Wisconsin ($95.02). The lowest states are Iowa ($58.46), Pennsylvania ($26.25) and Missouri ($20.33).
The psychotherapy codes were updated on 2026-01-01, so they reflect current policy. The individual session codes, including 90837, carry the same date and are listed on the state hub. For an outpatient practice, an above-median therapy rate that was refreshed this year is the most reliable part of Vermont's behavioral health schedule.
Vermont lists no prior authorization rules and no frequency limits on 90785, 90791, 90792, 90832, 90833, 90834, 90836 or 90837, nor on the crisis, family and group therapy codes. For an outpatient practice, an above-median therapy rate with no authorization step is a favorable combination.
Without managed care plans layering their own utilization review on top, the fee-for-service rule is the rule. That simplifies administration further: a Vermont practice can schedule intake and ongoing therapy without any approval workflow, while still keeping documentation that supports medical necessity for each session.
Mental health counseling is paid on H0036 with modifier HI at $20.91 per 15 minutes, or $83.64 an hour, effective 2025-07-01. At a $29.72 median counselor wage, wages take 50.5% of the rate, leaving $41.40 an hour after loaded wages.
The HI modifier identifies the program the comparison line belongs to. The same code under a different modifier or program can carry a different amount, so billing staff should confirm the exact line before setting revenue expectations. Because it is published per 15 minutes rather than per session, H0036 is not ranked against other states' counseling rates.
Vermont's community service rates have been in effect since 2004-01-01, and they now sit on opposite sides of the national median.
- Therapeutic behavioral services (H2019). $21.94 per 15 minutes, or $87.76 an hour. That is 0.1% below the $87.82 national median, effectively at it. At a $22.87 median psychiatric technician wage, wages take 37.0% of the rate, leaving $55.25 an hour after loaded wages.
- Skills training (H2014). $7.49 per 15 minutes, or $29.96 an hour, ranking 25th of 33 and 41.5% below the $51.20 national median. Wages take 108.5% of the rate, so the margin after loaded wages is negative.
- Wraparound (H2022). $356.79 a day. Because it is a daily rate rather than hourly, it is not ranked.
What a 2004 rate means today
The H2019 rate shows that an older rate is not necessarily a low one: it still sits at the national median. Skills training is the line where the old rate shows. Rhode Island pays $139.64 an hour on H2014, while Vermont's rate does not cover a median technician wage. Agencies that deliver skills training in Vermont should treat it as a cross-subsidized service and use the 2026 rate notices, discussed below, to press for updates.
Vermont does not appear among the highest or lowest states on any ranked behavioral health service. On therapeutic behavioral services, Maine pays $449.72 an hour, Wyoming $149.80 and Washington $145.40, while Wisconsin ($21.44), Arizona ($19.52) and Alabama ($16.80) are lowest; Vermont sits at the median between them. On skills training, the gap to the leaders is wider: Iowa pays $120.60 an hour and Delaware $119.68, against Vermont's $29.96.
The pattern is a state that pays mid-market or better on clinical services and below market on rehabilitation hours. Within New England, the contrast with Maine on therapeutic behavioral services and with Rhode Island on skills training is especially sharp; the New Hampshire behavioral health page shows a neighbor with a similar mid-market profile.
Vermont's May 2025 wages:
- Mental health counselor: $29.72, against $28.53 nationally
- Mental health social worker: $35.20, against $28.98
- Clinical psychologist: $40.04, against $48.36
- Psychiatrist: $145.56, against $135.51
- Nurse practitioner: $64.78, against $63.61
- Psychiatric technician: $22.87, against $21.70
Social workers earn well above the national median, at $35.20 an hour against $28.98. Clinical psychologists are the exception on the low side, which makes psychological testing comparatively affordable to staff. Psychiatrists earn above the national median, which makes psychiatric time expensive. Counselors cost less than social workers in Vermont, which favors counselor-staffed therapy.
Vermont pays behavioral health through Vermont Medicaid fee-for-service, administered by DVHA. Vermont's managed care rules are not classified for behavioral health, and our behavioral health data counts 3 plans. The Vermont managed care page has the detail.
Case rates and CCBHC demonstration payments pay on a different basis than the per-unit codes above. A case rate pays a fixed amount per person served over a period; a CCBHC payment covers the clinic's full range of services. For agencies paid this way, the fee schedule describes only part of how behavioral health is paid in Vermont.
Most of Vermont's recent behavioral health activity runs through GCR notices, effective 2026-07-01 unless noted:
- GCR 26-035, CCBHC Demonstration Year Two Expansion, final.
- GCR 26-050, Department of Mental Health Fee-For-Service Rate Increase, final.
- GCR 26-046, Mental Health Case Rate Update, proposed.
- GCR 26-062, Residential Substance Use Disorder Treatment Rate Increase, proposed.
- GCR 26-073, temporary rates for adult mental health residential and crisis services, final.
- GCR 26-081, rate increase for community-based mobile crisis services, proposed.
- GCR 26-047, Mental Health Micro-Residential Reimbursement Change, and GCR 26-100, adding another provider to the CCBHC Demonstration, both effective 2026-10-01.
For a Vermont provider, these notices matter more than the 2004 fee schedule lines. The Department of Mental Health increase and the mobile crisis proposal are the items most likely to change revenue for community agencies this year.
Vermont publishes fee-for-service rates in separate files by code type: a CPT file for psychotherapy and evaluation codes, and a HCPCS file for community codes such as H2019, H2014, H0036 and H2022. Within those files, the CPT-based therapy codes carry a 2026-01-01 date while several HCPCS community codes still show 2004-01-01, so an update to one group of codes does not imply an update to the other.
Units differ across the files. Therapy codes are paid per service, community codes in 15-minute increments, and wraparound by the day. Converting each to an hourly figure, as the table does, is the only fair way to compare them with each other and with wages. Billing staff should download both files after each update rather than assuming a change in one carries over to the other.
Vermont's 2026 notices concentrate on the most intensive levels of care. Temporary rates for adult mental health residential and crisis services were finalized, a residential substance use disorder treatment increase was proposed, micro-residential reimbursement is changing from 2026-10-01, and a mobile crisis rate increase was proposed. For residential and crisis operators, these notices are where 2026 revenue will move, and each should be read alongside the current contract or rate letter that governs the program.
- Separate payment models. Budget fee-for-service lines, case rates and CCBHC payments separately.
- Lead with therapy and H2019. Both sit at or above the national median.
- Track GCR notices. Most 2026 changes arrive as proposed and final GCRs.
- Benchmark in New England. The Maine hub shows the neighbor with the highest H2019 rate in the country.
National medians are on the behavioral health Medicaid rates by state overview, and plans for the full dataset are on the pricing page.
Rates are compiled from official Vermont Medicaid publications, including the Vermont Medicaid Fee Schedule for CPT and HCPCS codes and the state's GCR notices. Each rate links to its source document, and Vermont's history in our data goes back to 1990. Comparison groups match services across codes, hourly figures are converted from the published unit, and ranks include only states with a comparable rate. Wage figures are May 2025 medians. See the methodology page.