Private duty nursing Medicaid rates in Wyoming come through the waiver side, and their defining feature is how close the LPN rate sits to the RN rate. Wyoming Medicaid pays $18.86 per 15 minutes on code T1003 for LPN nursing, or $75.44 an hour, which ranks 10th of 34 states and sits 33.7% above the $56.42 national median. RN nursing on T1002 pays $79.08 an hour, 19th of 41 states, just 1.9% above its median.
With LPN wages far below RN wages, that narrow gap makes LPN staffing the more profitable model in Wyoming. Every rate here is compiled from official state Medicaid publications and links to its source document on the Wyoming Medicaid rates page.
Wyoming bills in-home nursing in 15-minute units:
| Service | Code | Per 15 min | Per hour | Rank | vs national median | Effective |
|---|---|---|---|---|---|---|
| Waiver nursing, RN | T1002 | $19.77 | $79.08 | 19 of 41 | +1.9% | 2025-09-01 |
| Waiver nursing, LPN | T1003 | $18.86 | $75.44 | 10 of 34 | +33.7% | 2023-04-01 |
The RN rate is recent; the LPN rate has held since 2023. At $19.77 against $18.86 per 15-minute unit, the payer adds little premium for RN time.
That structure is unusual in a useful way for agencies. Nationally, the waiver nursing median is $77.60 for RNs and $56.42 for LPNs, so in a typical state the savings on an LPN's lower wage are partly offset by lower revenue. In Wyoming, an LPN hour earns nearly the same revenue as an RN hour while costing the agency much less in wages.
The two ranks tell the same story from another angle. Wyoming's RN rate sits near the middle of the national table, while its LPN rate is in the top ten. A state that pays LPN time close to RN time is, in effect, valuing the hour of nursing more than the credential behind it.
For care planning, this does not change who should deliver care. The level of nurse is set by the participant's needs and the service plan. What it changes is the financial cost of the right answer: in Wyoming, an agency loses little revenue when the plan calls for LPN care.
Our data do not include a ranked Wyoming rate for state plan private duty nursing on S9123, S9124 or T1000. Wyoming therefore does not appear in the national RN and LPN private duty nursing rankings on the private duty nursing hub. T1002 and T1003 are the reference rates for Wyoming agencies.
In practice, this puts the waiver programs at the center of an agency's Wyoming business. An agency planning to enter the state should map which waivers its target population is enrolled in before it plans staffing or locations.
Wyoming's nurse wages sit below the national median. Federal wage data for May 2025 put the state median at $40.27 an hour for registered nurses (US: $46.90) and $30.51 for licensed practical nurses (US: $30.96).
After loaded wages:
- RN nursing: loaded wage share 72.4%, leaving a margin of $21.84 an hour.
- LPN nursing: loaded wage share 57.5%, leaving a margin of $32.08 an hour.
"Loaded" means the wage plus employer costs such as payroll taxes and benefits. The LPN line leaves more per hour than the RN line. For agencies, that is the central staffing signal in Wyoming: wherever a participant's service plan allows LPN care, an LPN shift funds supervision, travel and on-call coverage more comfortably than an RN shift. RN staffing still covers its cost, so high-acuity cases that require RNs remain viable.
Both margins also leave room to pay above the state median wage, which matters for recruiting nurses willing to work long shifts in clients' homes.
Wyoming's home-based services run through the Wyoming DD waivers (Comprehensive and Supports) and the Wyoming Community Choices Waiver for elderly and physically disabled adults. Wyoming Medicaid's fee-for-service program is run by the Department of Health.
DD waivers and T1002
The RN rate on T1002 is published under the DD waivers, and the source schedule is the Comprehensive and Supports Waivers Fee Schedule effective September 1, 2025, which matches the RN rate's effective date. Participants on these waivers often have long-term, stable care needs.
Community Choices and T1003
The LPN rate on T1003 is published under the Community Choices Waiver, which serves older adults and people with physical disabilities. These cases can change quickly as health declines, so authorization updates matter.
For agencies, the participant's waiver determines the service plan, the authorized hours and the care team the nurse works with. The Wyoming IDD rates page and Wyoming home care rates page cover the other services these waivers fund.
Travel deserves particular attention for home-based nursing in Wyoming. Quarter-hour billing pays for time with the client, so drive time between visits is a cost the margin must absorb.
Three practices help:
- Cluster cases geographically so one nurse serves nearby participants on the same day.
- Favor longer shifts where the service plan allows, since a long visit spreads one round trip over more billable units.
- Track unbillable time separately, so the real cost of each case is visible.
The healthy margins on both lines give agencies room to absorb travel, but only if it is managed.
Our coverage data list two prior authorization rules on T1002 and one on T1003. No unit limits are listed. The authorization on each participant's service plan sets the hours an agency can deliver, so intake and reauthorization are where agencies protect revenue. The lighter rule count on T1003 is one more practical advantage of LPN staffing in Wyoming.
A simple tracker of authorization end dates, reviewed each week, prevents the most common cause of unpaid nursing hours: services delivered after an authorization lapses.
Fifteen-minute billing rewards accurate records. Every unit on a T1002 or T1003 claim should trace back to a visit note that shows the start time, the end time, the nurse's credential and the tasks performed under the service plan.
Two habits make audits routine rather than costly:
- Bill the credential that delivered the care. An LPN shift billed on the RN code, or the reverse, prices the claim at the wrong rate and is a common finding in waiver reviews.
- Reconcile units to the authorization each week. Delivered units above the authorized total are rarely paid, and the gap is cheaper to catch before the claim is filed.
Clean records also make reauthorization faster, because the agency can show exactly how the authorized hours were used.
Wyoming Medicaid runs on a fee-for-service basis and classifies no service lines under a managed-care payment rule. Our records list 18 plan arrangements in the state, but they are care-management programs and coverage groups rather than risk-based plans that set their own rates: the Wyoming Care Management Entity run by Magellan Healthcare, WYhealth Health Management, Wyoming Kid Care CHIP and Medicaid coverage groups such as ABD Long-Term Care.
For a nursing agency, that means one payer and one schedule. There is no plan contract to negotiate, and a state rate change reaches every case on the same date. The Wyoming managed care page shows the full list.
Wyoming's 2026 budget session (SF0001, Enrolled Act 27) carries a Department of Health footnote on DD/ID/ABI provider rates effective July 1, 2026, and a provider bulletin issued 9/23/2026 announced provider rate changes effective the same date. The state also published a DD Waiver Fee Schedule effective July 22, 2026.
Our current T1002 rate carries the 2025-09-01 date and T1003 the 2023-04-01 date. Agencies should compare the newer DD waiver schedule against their billed rates and confirm whether nursing codes moved. The LPN rate in particular has been flat since 2023, so any update would change the staffing math described above.
For LPN waiver nursing, the top five are Utah ($345.48), Maryland ($123.08), Vermont ($104.12), Georgia ($97.44) and Connecticut ($96.32). The lowest are California ($24.72), North Carolina ($13.92) and Arkansas ($12.68). Wyoming's $75.44 sits in the top ten.
For RN waiver nursing, Georgia leads at $146.72, followed by Vermont, Maryland, Utah and New Mexico ($119.04); North Carolina ($34.88), Florida ($32.64) and Arkansas ($19.08) are lowest. Wyoming's $79.08 sits at the middle.
- Budget with both margins. Model RN and LPN hours separately, since the LPN line leaves more per hour.
- Plan recruiting around the margin. Both lines leave room to offer wages above the state median.
- Watch the July 2026 updates. Confirm the DD waiver schedule before billing new dates of service.
- Benchmark against neighbors. Utah and New Mexico are nearby states with higher waiver nursing rates and are useful comparisons in rate discussions.
The full Wyoming dataset holds all 47,114 current Medicaid rates, including every waiver code and effective date, through a MedicaidRate plan.
Rates on this page are compiled from official state Medicaid publications, including the Comprehensive and Supports Waivers Fee Schedule and Wyoming Medicaid fee schedules from the Department of Health, and each rate links to its source document. Hourly figures are four 15-minute units, national ranks compare each state's published rate for the same service and provider level, and wages are May 2025 federal occupational medians. Our methodology explains how rates are compared.