Therapy Medicaid rates in Indiana pair an old treatment schedule with new evaluation rates. Indiana Medicaid pays $72.48 an hour for physical therapy under code G0151, which ranks 42nd of 49 states and is 24.5% below the national median of $96.04. The rate is $18.12 per 15-minute unit, billed with the U5, U7 or UA modifier, and it has been in effect since 2014-01-01.
The PT and OT evaluation codes, by contrast, carry a 2026-01-01 effective date and pay $93.69 and $96.07. That split, a treatment rate unchanged for more than a decade alongside freshly published evaluation rates, is the defining feature of the Indiana therapy schedule. All rates are compiled from official Indiana Health Coverage Programs (IHCP) publications, and the Indiana Medicaid rates hub links each to its source document.
- Physical therapy, G0151: $18.12 per 15 minutes ($72.48 an hour), 42nd of 49 states, 24.5% below the median.
- Occupational therapy, G0152: $17.99 per 15 minutes ($71.96 an hour), 43rd of 48 states, 34.9% below the median.
- Speech therapy, 92507: $18.12 per 15 minutes ($72.48 an hour).
- PT evaluation, 97161: $93.69 per unit, effective 2026-01-01.
- OT evaluation, 97165: $96.07 per unit, effective 2026-01-01.
The three treatment rates share the same modifiers and the 2014-01-01 effective date. Occupational therapy sits further below its median than PT because the national OT median, $110.60, is higher than the PT median.
Indiana's physical and occupational therapy rates on file are billed under HCPCS codes G0151 and G0152 rather than the CPT treatment codes most states use for their headline rates. Speech therapy uses 92507, but with the same U5, U7 and UA modifiers and the same 15-minute unit.
Why the code set matters
Billing teams moving between states should map those codes carefully. The rate attaches to the code-and-modifier combination, so a claim built on another state's coding template may price differently, or not at all, in Indiana. CPT therapy codes are also listed on the IHCP Professional Fee Schedule with their own prices and dates, so a practice should confirm which code set applies to its provider type before building a billing template.
State-specific modifiers
U-series modifiers are defined by each state rather than nationally. In Indiana, U5, U7 and UA are part of the priced combination for all three treatment rates. A claim missing the expected modifier is one of the most common reasons a therapy line prices at zero or is denied.
Indiana pays $18.12 per 15-minute unit of G0151, or $72.48 an hour. That rate has not changed since 2014-01-01, making it one of the oldest therapy rates in our national data. In the years since, therapist wages, rent and documentation burdens have all grown, so the real value of the rate has fallen even though the dollar figure has not.
For a practice deciding whether to grow Indiana Medicaid therapy volume, the age of the rate is as important as its level. A rate that has not moved in more than a decade gives no signal that it will move soon, so plans should assume it stays at $72.48 an hour.
The unit structure also shapes daily revenue. Because each 15-minute unit pays $18.12, a session that delivers three units of direct treatment earns three-quarters of the hourly figure, even if the patient was in the clinic for a full hour. Practices that measure productivity by billed units rather than scheduled time get a truer picture of what Indiana Medicaid actually pays per therapist hour, and of how much time is lost to set-up, transitions and documentation between units.
Indiana therapy wages run slightly below the national medians. In May 2025, physical therapists earned a median $48.83 an hour against $49.40 nationally, occupational therapists $46.65 against $48.24, and speech-language pathologists $42.00 against $47.05. Physical therapist assistants earned $31.39 against $32.88, and occupational therapy assistants $32.05 against $34.76.
Against treatment rates fixed since 2014, those wages leave little:
| Service | Rate per hour | Median wage | Wage share | Margin per hour |
|---|---|---|---|---|
| Physical therapy | $72.48 | $48.83 | 95.8% | $3.08 |
| Occupational therapy | $71.96 | $46.65 | 92.1% | $5.66 |
| Speech-language therapy | $72.48 | $42.00 | 82.4% | $12.79 |
Speech therapy has the widest margin because Indiana's SLP wage is furthest below the national figure while the speech rate matches PT. Even so, $12.79 an hour after a loaded wage has to cover documentation, cancellations and overhead. For PT and OT, $3.08 and $5.66 leave almost no room.
With PT and OT margins in single digits, Indiana practices depend on operational choices more than on the rate.
Assistants and supervision
Physical therapist assistants earn $31.39 and occupational therapy assistants $32.05 at the Indiana median, far below the therapists. Where Indiana rules allow, assistant-delivered treatment under a therapist's plan of care is the most direct way to create margin on a $72 hour.
Speech as the stronger line
Speech-language pathology carries both the widest margin and the heaviest authorization load. Practices that build a speech program in Indiana should staff the authorization work explicitly rather than leaving it to clinicians.
Payer mix
Most Indiana practices will treat Medicaid therapy as part of a broader mix. The evaluation rates help, but the treatment hours that follow are priced well below the median.
The 2026-01-01 evaluation rates are the brighter part of Indiana's schedule. A PT evaluation under 97161 pays $93.69, and an OT evaluation under 97165 pays $96.07. Both are above the national medians for those services ($81.72 for PT and $82.41 for OT), though neither is ranked on the national table.
For a practice, the evaluation visit is worth more than an hour of treatment in Indiana. That shifts the economics toward intake: clinics with steady referral flow and well-documented plans of care get relatively more from the Indiana schedule than clinics built on long treatment courses. Re-evaluations need more care, as the next section shows.
Indiana attaches authorization rules unevenly:
- G0151, G0152 and 92507: six prior-authorization rules each.
- 97110, 97112, 97530, 97533, 97164 and 97168: two rules each.
- 97161, 97162, 97163 and 97165 (initial evaluations): no prior-authorization rule.
No unit limits are listed. Initial evaluations can proceed without prior authorization, but treatment needs approval in place. The six rules on the three headline treatment codes make authorization the main administrative cost of Indiana Medicaid therapy, and the re-evaluation codes 97164 and 97168 also need approval, so a re-assessment cannot be scheduled on the assumption that it is covered like the first evaluation.
Indiana works with managed-care plans including Anthem, CareSource, Managed Health Services (MHS), Humana and UnitedHealthcare, plus several PACE programs; our data counts 16 plans in total. For physical, occupational and speech therapy, the rule on file is that plans must pay at least the published rate.
That is a stronger floor than in states where plans negotiate freely. It means the IHCP rate is the minimum a therapy practice should see on a managed-care claim, and a plan payment below it is worth disputing. Indiana applies the same floor to physician services, hospital outpatient care and home health, so the published schedule anchors most of the program. The Indiana managed-care page lists the plans on file.
Reading managed-care remittances
Because the floor applies, billing staff can audit plan payments line by line against the IHCP schedule. Underpayments on low-margin therapy lines add up quickly, and with PT margins near $3 an hour, a small shortfall can turn a visit into a loss.
IHCP has announced changes to the Professional Fee Schedule for 2027 in bulletin BT2026143. Practices billing CPT therapy codes should check that bulletin and the next edition of the schedule. The G-code treatment rates have not moved since 2014, so any change touching them would be notable.
On physical therapy, Indiana's $72.48 is far below Alaska ($176.68), New Mexico ($165.64) and Montana ($147.04), and closer to the bottom group of New Jersey ($58.80), California ($48.88) and Maine ($46.64). Neighboring Illinois therapy rates pay far more for occupational therapy but almost nothing for evaluations, the reverse of Indiana's pattern.
- Budgeting: model treatment at $72.48 an hour for PT and speech and $71.96 for OT, and evaluations at $93.69 and $96.07.
- Billing setup: build templates around G0151, G0152 and the U-series modifiers.
- Audit: compare every managed-care payment with the published rate, which plans must meet.
- Authorization: plan for six rules on each headline treatment code.
- Benchmarking: compare Indiana with neighboring states before shifting therapist capacity across a state line.
Rates on this page are compiled from official IHCP publications, including the IHCP Professional Fee Schedule. Each rate links to its source document. Hourly figures convert 15-minute units to an hour; ranks compare the same service across states. Wages are May 2025 medians.
This page covers therapy only; the Indiana Medicaid rates hub covers all 28,364 current Indiana Medicaid rates. See the national therapy rates hub, our methodology and pricing.