Therapy Medicaid rates in South Dakota are comfortably above the national median, and they meet therapy wages well below the national medians. South Dakota Medicaid pays $111.32 an hour for code 97110, therapeutic exercise, which ranks 13th of 49 states and is 15.9% above the national median of $96.04. Every therapy measure ranks between 8th and 13th, and every one took effect on July 1, 2026.
South Dakota is also one of the simplest states to bill. Therapy runs through a single fee-for-service schedule with no risk-based plans in between and no prior authorization rules on the core codes. All rates below are compiled from official South Dakota Medicaid publications, and each one links to its source document.
South Dakota is a consistent upper-tier state rather than a leader on any single line.
| Service | Code | South Dakota rate | Rank | vs national median |
|---|---|---|---|---|
| Physical therapy | 97110 | $111.32 / hour | 13 of 49 | +15.9% |
| Occupational therapy | 97530 | $134.56 / hour | 12 of 48 | +21.7% |
| Speech-language therapy | 92507 | $73.27 | 8 of 39 | +18.9% |
| PT evaluation | 97161 | $94.23 | 11 of 46 | +15.3% |
| OT evaluation | 97165 | $96.80 | 11 of 46 | +17.5% |
| Speech-language evaluation | 92522 | $107.12 | 11 of 44 | +17.3% |
Every line sits between 15.3% and 21.7% above its national median. The schedule does not favor treatment over evaluation, or one discipline over another, so a South Dakota practice can grow in any direction without hitting a weak rate.
South Dakota publishes code 97110 at $27.83 per 15-minute unit, with no modifier, which converts to $111.32 an hour. For a PT clinic, four documented units in an hour of one-on-one treatment produce that figure, and it comfortably covers a South Dakota physical therapist's wage.
The rate is current. Because it took effect July 1, 2026, it already includes the state's latest annual adjustment, and South Dakota's appropriations process makes further adjustments a regular event rather than a rare one.
Occupational therapy on code 97530 pays $33.64 per unit, or $134.56 an hour, the strongest hourly figure on the schedule. South Dakota pays OT a clear premium over PT, in line with the national pattern where the OT median is higher than the PT median.
Paired with an occupational therapist median wage of $40.89, that rate gives OT the widest margin of any discipline in the state. For a group deciding which service to add, OT is the line where South Dakota Medicaid pays most generously relative to cost.
South Dakota prices therapy in the South Dakota Medicaid Physician fee schedule, published for state fiscal year 2027 with a July 1, 2026 effective date. Two kinds of codes behave differently.
Timed treatment codes
97110, 97112 and 97530 pay per 15-minute unit. Revenue follows documented treatment time, so units per visit is the productivity measure to watch.
Per-visit codes
Evaluations and 92507 pay once per service, regardless of length. Because South Dakota's evaluation rates rank 11th nationally, evaluation-heavy days do not drag down revenue the way they do in states with weak evaluation rates.
The 97161 PT evaluation pays $94.23 and the 97165 OT evaluation pays $96.80, each 11th of 46. The 92522 speech evaluation pays $107.12, 11th of 44.
Clinics with short episodes, where evaluations make up a larger share of visits, are not penalized in South Dakota the way they are in states with low evaluation rates. That makes the state a good fit for orthopedic practices with quick turnover and for pediatric programs that assess many children and treat some of them.
Speech therapy is South Dakota's best-ranked line. The state pays $73.27 for code 92507, 8th of 39 ranked states and 18.9% above the national median of $61.64.
The speech wage data makes that rate even more significant. South Dakota's median speech-language pathologist wage was $31.58 an hour in May 2025, against $47.05 nationally. For a pediatric speech practice, an above-median rate paired with a wage this far below the median is an unusually favorable combination. The catch is the other side of the same number: a low wage market can make speech-language pathologists hard to recruit and retain.
Federal occupational data for May 2025 gives these South Dakota median hourly wages, with US medians in parentheses:
- Physical therapist: $44.55 ($49.40)
- Occupational therapist: $40.89 ($48.24)
- Speech-language pathologist: $31.58 ($47.05)
- Physical therapist assistant: $23.71 ($32.88)
- Occupational therapy assistant: $27.01 ($34.76)
Every role is well below its national median, and the assistant wages are especially low.
Applied to the Medicaid rates:
- Physical therapy. The PT wage is 56.9% of the $111.32 hourly rate, leaving a margin of $48.00 an hour after a loaded wage.
- Occupational therapy. The OT wage is 43.2% of the $134.56 rate, leaving $76.44 an hour.
The practical constraint in South Dakota is more likely to be recruiting therapists into a lower-wage market than the Medicaid rate itself, and the margins leave room to pay above the local median when needed. Rural distance is the other cost the margin has to cover: travel time between patients in a sparsely populated state is unbillable, and a schedule this healthy is what makes serving those areas possible.
The South Dakota schedule attaches no prior authorization rule to 92507, 97110, 97112, the 97161 evaluation or the speech evaluation codes 92521 through 92524, and no therapy code has a published unit limit. The full set of PT and OT evaluation codes and 97530 is also free of schedule-level authorization rules.
That keeps billing simple, but it does not remove the need for good documentation. Program policy still governs medical necessity and plans of care, and a claim that lacks a supportable plan can be recouped later even when it paid on submission.
In a state with few administrative gates, the practice itself becomes the main control on quality. A short internal checklist helps: a signed plan of care before treatment starts, goals that justify the frequency billed, progress notes that tie each visit to those goals, and a re-evaluation when the plan changes. Those steps cost little and protect revenue that South Dakota's schedule pays generously.
South Dakota's therapy rates come from South Dakota Medicaid (fee-for-service, DSS Division of Medical Services). The state's coverage data names 4 plans and program arrangements: PRIME primary care case management providers, Care Connect health home providers, BabyReady designated providers and Delta Dental of South Dakota as the dental vendor. None of these reprices therapy claims, so the published schedule is the rate a practice bills.
People with developmental disabilities may also receive services through the South Dakota CHOICES Waiver or the Family Support 360 Waiver, which run on their own rates. Older adults and adults with physical disabilities may be served through the HOPE Waiver. Therapists who work with waiver participants should confirm whether a given service is billed to the waiver or to the Medicaid therapy schedule before the visit. See the South Dakota managed care page for how each arrangement works.
South Dakota's SFY2027 General Appropriations Act, HB 1326, funded discretionary provider inflation of 1.4% across several budget lines, including Medical Services and Rehabilitation Services, effective July 1, 2026. The Department of Social Services followed with its SFY27 reimbursement methodology and rate updates on the same date. That annual cycle is what put every therapy code on this page on a July 1, 2026 effective date.
For planning, the pattern suggests modest annual increases set by the legislature each spring and applied each July. A practice can reasonably model future rates as this year's schedule plus a small legislative adjustment, and confirm each spring once the appropriations act passes.
South Dakota trails the leaders. Alaska pays $176.68 an hour for 97110, New Mexico $165.64 and neighboring North Dakota $129.16. On speech, Washington leads at $144.10 for 92507.
It is far ahead of the bottom. New Jersey pays $58.80 an hour for PT, California $48.88 and Maine $46.64, while Nebraska, Pennsylvania and New Hampshire pay near $20 for speech.
- Budgeting. Use the July 2026 rates for all disciplines, including evaluations, and plan for a small legislative adjustment each July.
- Recruiting. Treat part of the margin as a recruiting and retention budget, especially for speech-language pathologists.
- Benchmarking. Compare your blended Medicaid revenue per therapist hour with the $111.32 PT and $134.56 OT figures; a large gap usually points to low units per visit, denied claims or clinician hours lost to unbilled travel.
- Service planning. With OT the strongest line and evaluations paid well, multi-discipline pediatric and rural outreach models are well supported.
The full dataset covers all 41,546 current South Dakota Medicaid rates, with history back to 1988. See pricing for access.
Rates on this page are compiled from official South Dakota Medicaid publications, chiefly the South Dakota Medicaid Physician fee schedule for SFY2027, and each rate links to its source document. For the national picture, see therapy Medicaid rates by state. Every other code is on the South Dakota Medicaid rates hub, and our methodology explains how units are converted to hourly rates.