Therapy Medicaid rates in Washington pull in opposite directions by discipline. Washington Apple Health pays $144.10 for speech therapy on code 92507, the highest of 39 ranked states and 133.8% above the national median of $61.64. Physical therapy goes the other way: the ranked PT rate is $79.48 an hour, 39th of 49 states and 17.2% below the national median of $96.04. Washington is also the only state that leads a therapy discipline without leading the evaluation codes.
Every rate below is compiled from official Washington Medicaid publications, and each one links to its source document.
92507 Washington Medicaid rate: first in the nation
Washington publishes code 92507 at $144.10, with no modifier, effective January 1, 2025. The next-highest states are Alaska at $118.16, Arizona at $109.12 and Texas at $107.78. At the bottom of the ranking, Pennsylvania, Nebraska and New Hampshire pay between $19.57 and $21.70 for the same code.
For a pediatric speech practice, Washington pays more per 92507 treatment visit than any other ranked state. A caseload built on weekly or twice-weekly speech treatment benefits most. Speech-language pathologists in Washington earn a median of $50.74 an hour, above the US median of $47.05, but the 92507 rate leaves ample room above that wage.
The speech evaluation is a different story. The 92521 evaluation pays $80.64, 31st of 44 states and 11.7% below the national median of $91.32. In Washington, speech revenue is earned on treatment visits, not on intake.
Washington Medicaid therapy reimbursement by service
| Service | Code | Washington rate | Rank | vs national median |
|---|---|---|---|---|
| Physical therapy | 97112 | $79.48 / hour | 39 of 49 | -17.2% |
| Occupational therapy | 97533 | $150.60 / hour | 7 of 48 | +36.2% |
| Speech-language therapy | 92507 | $144.10 | 1 of 39 | +133.8% |
| PT evaluation | 97162 | $59.43 | 41 of 46 | -27.3% |
| OT evaluation | 97166 | $61.15 | 41 of 46 | -25.8% |
| Speech-language evaluation | 92521 | $80.64 | 31 of 44 | -11.7% |
Occupational therapy is also strong. The ranked OT rate is on code 97533 at $37.65 per 15 minutes, or $150.60 an hour, 7th of 48. OT practices billing code 97530 should check that code on the Washington Medicaid rates hub too.
Physical therapy and all three evaluations are below median. The ranked PT figure is on code 97112 at $19.87 per unit, and the PT and OT evaluations both rank 41st of 46.
Wages and margins: OT and speech versus PT
Washington therapy wages run above national levels. Federal occupational data for May 2025 gives these medians, with US figures in parentheses:
- Physical therapist: $50.94 ($49.40)
- Occupational therapist: $51.77 ($48.24)
- Speech-language pathologist: $50.74 ($47.05)
- Physical therapist assistant: $31.95 ($32.88)
- Occupational therapy assistant: $37.30 ($34.76)
The result is a sharp split by discipline:
- Physical therapy. The PT wage is 91.1% of the $79.48 hourly rate, leaving a margin of only $7.08 an hour after a loaded wage.
- Occupational therapy. The OT wage is 48.9% of the $150.60 rate, leaving $77.02 an hour.
A Washington practice with all three disciplines should expect its Medicaid PT line to run close to break-even while OT and speech carry the margin. Physical therapist assistants in Washington earn slightly less than the national median, which is the main lever for improving the PT line where assistant-delivered treatment is allowed.
Apple Health managed care and negotiated therapy rates
For physical, occupational and speech therapy, Washington's rule is that plans negotiate; the published rate applies out of network. The Washington Apple Health (Medicaid) fee-for-service schedule is therefore the out-of-network rate and the benchmark in contract talks with plans such as Amerigroup, Community Health Plan of Washington, Coordinated Care of Washington and Molina Healthcare of Washington. The state's coverage data names 51 plans and program arrangements, including tribal clinics and PACE.
For speech practices, that matters a great deal. A plan offer far below the $144.10 fee-schedule rate for 92507 is a large discount from the state's own benchmark, and practices should negotiate with the schedule in hand. For PT practices, the schedule rate is a weaker anchor, since it already sits below the national median. See the Washington managed care page for each plan.
Prior authorization and coverage rules
The Washington 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. Apple Health plans set their own authorization rules for enrolled members.
How Washington compares with other states
On speech, Washington is first. On OT it trails only a few states, including Alaska at $338.72 an hour on 97533 and New Mexico at $198.64. On PT, it sits well below the leaders, Alaska at $176.68 an hour for 97110 and New Mexico at $165.64, though still above New Jersey at $58.80, California and Maine.
For the national picture, see therapy Medicaid rates by state, and our methodology explains how 15-minute units are converted to hourly figures.
Updated 2026-10-05