Home health Medicaid rates in West Virginia were reset recently and across the board. West Virginia Medicaid pays $125.34 for skilled nursing on revenue code 0551, $137.00 for physical therapy on 0421, $137.93 for occupational therapy on 0431, $148.91 for speech therapy on 0441 and $56.75 for aide services on 0571, every one effective since 2026-04-01. These rates are published under institutional revenue codes without a unit that matches the 15-minute and hourly scales used for national ranking, so West Virginia is reported in its own terms rather than ranked.
For a West Virginia home health agency, the most important context is not a rank but the gap between these rates and the state's wages, which run below the national median for every home health role. A schedule that looks ordinary on paper can carry real margin when the labor underneath it costs less.
| Discipline | Revenue code | West Virginia rate |
|---|---|---|
| Skilled nursing | 0551 | $125.34 |
| Aide | 0571 | $56.75 |
| Physical therapy | 0421 | $137.00 |
| Occupational therapy | 0431 | $137.93 |
| Speech therapy | 0441 | $148.91 |
Speech therapy is the highest-paid discipline, followed by occupational and physical therapy, which sit within a dollar of each other. Skilled nursing sits just below the therapy rates. Aide services pay the least.
The single 2026-04-01 effective date means the whole home health schedule was updated together. For an agency, that makes it simple to confirm that claims are priced on the current schedule: anything with an earlier date of service may be on the prior rates. The skilled nursing line also has its own reference page for revenue code 0551, which shows how other states that publish the same code price it.
West Virginia publishes home health the way a hospital bills: on revenue codes, the four-digit codes institutional providers put on a claim to identify a department or discipline. Each discipline gets one code and one rate. There are no separate rows for evaluations, extended visits or visit lengths, which keeps the schedule short and easy to load into a billing system.
What the revenue code tells you
- 0551 is skilled nursing, billed for both registered nurse and licensed practical nurse visits.
- 0571 is the home health aide line.
- 0421, 0431 and 0441 are physical, occupational and speech therapy.
Why there is no hourly figure
The schedule does not state whether each payment covers a visit, an hour or another unit. That is why West Virginia sits outside the national ranking, which compares states on a common per-hour or per-visit basis. An agency should read each rate as the amount West Virginia pays per billed unit of that revenue code and build its cost model around the way it actually bills.
Therapy is where West Virginia's schedule is most generous relative to its own nursing and aide rates. Speech therapy at $148.91 is the top line on the schedule, and occupational therapy at $137.93 and physical therapy at $137.00 both sit above skilled nursing.
For a home health agency, the therapy lines matter for two reasons. They pay more per unit than any other discipline, and the therapists who deliver them earn close to national wages in West Virginia rather than far below them, so the margin story differs from nursing. A physical therapist earns a $46.44 median in the state against $49.40 nationally, and an occupational therapist $46.25 against $48.24. The gap is much wider for speech-language pathologists, at $38.93 against $47.05, which makes speech therapy both the highest-paid line and the one with the most favorable wage gap.
The national figures give some context even without a West Virginia rank. Physical therapy in home health has a national median of $120.52 an hour across ranked states, led by Michigan at $343.72.
West Virginia is a low-wage state for every home health role. Federal wage data for May 2025:
- Registered nurses: $38.52 an hour, against $46.90 nationally.
- Licensed practical nurses: $26.61, against $30.96.
- Home health and personal care aides: $13.47, against $17.21.
- Physical therapists: $46.44, against $49.40.
- Occupational therapists: $46.25, against $48.24.
- Speech-language pathologists: $38.93, against $47.05.
The gap is widest for registered nurses and speech-language pathologists. Those are also the two disciplines where West Virginia's rates are strongest relative to the other lines: skilled nursing at $125.34 and speech therapy at $148.91.
That combination works in an agency's favor. A skilled nursing visit priced at $125.34, staffed by a nurse at the $38.52 median wage, leaves more room for travel, documentation and supervision than the same rate would in a high-wage state. The constraint in West Virginia is less likely to be the rate than the ability to recruit staff at local wages and cover long drives between homes.
Revenue code 0551 pays $125.34 whether the visit is made by a registered nurse or a licensed practical nurse. That single rate gives an agency a staffing lever. A licensed practical nurse earns a $26.61 median in West Virginia, well below the $38.52 registered nurse median, so routine visits that fall within an LPN's scope carry more margin than the same visit made by an RN.
The lever has limits. Assessments, care plan changes and supervision stay with registered nurses, and a schedule that leans too hard on LPNs runs into supervision requirements and quality review. The practical approach is to match each visit type to the lowest licensed level that can safely deliver it, then check that the average cost per 0551 unit stays comfortably below $125.34 once travel time and documentation are included.
Aide services are the tightest line. At $56.75 and a $13.47 median wage, the aide line can still work, but only with efficient scheduling. The aide rate has less room than the nursing and therapy lines for unpaid drive time, missed visits and supervision.
For context, aide visits have a national median of $52.32 across 14 ranked states. The top states are Minnesota at $80.62 and Utah at $79.96; the bottom are North Dakota ($20.56), Hawaii ($20.00) and Florida ($18.04). West Virginia's $56.75 aide figure is in the same range as the per-visit states, though its unit is not stated.
Aide recruiting is the other pressure. Home health aides compete with personal care and waiver programs for the same workers, and West Virginia's HCBS and personal care rate increases effective October 1, 2025 raised those competing rates by 6.12%. That increase did not apply to the home health revenue codes, so agencies that employ aides on both sides should expect wage pressure from the waiver side.
West Virginia applies different managed care rules to home health and to therapy, and an agency that bills both needs to track the difference.
- Home health. Plans negotiate their own rates, and the published rate applies out of network. An agency in a plan's network is paid its contract rate; one outside the network is paid the published rate.
- Physical, occupational and speech therapy. These services are paid directly by the state, outside managed care. The published rate is the rate.
West Virginia counts 5 plans in its managed care program, Mountain Health Trust: Aetna Better Health of West Virginia, Highmark Health Options West Virginia, The Health Plan of West Virginia, UniCare Health Plan of West Virginia and Wellpoint West Virginia. With only five plans, an agency can hold contracts with every plan in the state, and each contract can be compared directly against the 2026-04-01 schedule.
The state has classified 21 service lines and binds plans to the published rate on 10 of them. Home health is not one of the lines with a floor, which is why contract terms matter. The West Virginia managed care page lists the rule for each service line.
Because West Virginia's rates are not converted to a common unit, they cannot be ranked against other states. Neighboring schedules still matter for agencies that operate across state lines or recruit from the same labor pool.
Nearby Ohio is the lowest-listed state for therapy, at $19.08 an hour for physical and occupational therapy, while Indiana pays $74.52 an hour for physical therapy. Those figures are per hour, so they cannot be set directly against West Virginia's per-unit revenue code rates, but they show how differently states structure the same benefit. Agencies working across the northern border can compare these figures with the Pennsylvania home health page, and those in the east with the Virginia home health page.
West Virginia's fee-for-service program is run by the Bureau for Medical Services, which publishes the home health schedule above. Alongside the state plan home health benefit, West Virginia operates the Aged and Disabled Waiver (ADW), the Intellectual/Developmental Disabilities Waiver (IDDW) and the Traumatic Brain Injury Waiver (TBIW), which pay their own schedules for in-home supports. These waiver services, along with personal care and private duty nursing, are paid directly by the state, outside managed care.
An agency that also provides waiver services should treat those as separate rate sets from the home health codes discussed here. A home health aide visit on revenue code 0571 and an in-home support hour under a waiver may involve similar work, but they are authorized, billed and paid under different rules.
West Virginia's current home health source is titled Home Health Agencies, effective 4/1/2026-3/31/2027. Many of the state's practitioner, dental and equipment schedules follow the same April-to-March rate year, so the next scheduled reset for home health falls at the start of April.
Several recent West Virginia notices touch adjacent services rather than home health itself: SPA 26-0003 on the nursing facility reimbursement methodology, effective 2026-07-01, and SPA 26-0004 on value-based payments for substance use disorder providers, proposed to take effect 2027-07-01. The Mountain Health Trust SFY2026 contract renewed the minimum fee schedules and directed payments that apply to plans on other lines.
For a home health agency, the useful habit is to check each April whether the revenue code rates moved, and to read any state plan amendment that names home health or aide services before it takes effect.
- Budget per discipline. Build a cost per unit for each revenue code using local wages, travel and documentation time, and compare it with the rate. Aide and nursing lines need the closest watching.
- Negotiate from the schedule. For home health contracts with the five plans, the published rate is the out-of-network fallback, which makes it a natural starting point. Therapy contracts need no negotiation because the state pays them directly.
- Benchmark staffing. Use the gap between state and national wages to judge whether recruiting offers are competitive, especially for speech-language pathologists and registered nurses.
- Check dates of service. Claims for services before 2026-04-01 may price on the earlier schedule.
The full West Virginia dataset covers all 88,707 current West Virginia Medicaid rates, including history back to 2017, for agencies that need every line rather than the five summarized here.
Every rate here is compiled from official West Virginia Medicaid publications and links to its source document. The home health figures come from the Bureau for Medical Services schedule Home Health Agencies, effective 4/1/2026-3/31/2027. Wage figures are federal occupational medians for May 2025.
See the West Virginia Medicaid rates page for the full schedule, the national home health overview for all states, hospice rates in West Virginia for the adjacent benefit, and our methodology for how rates are converted and ranked.