Georgia Medicaid reimbursement rates
20,899 current fee-for-service and managed-care rates from Georgia Medicaid, across 83 services and 6 programs, normalized by code, provider level and unit. Each links to one of 217 official source documents.
Last retrieved 2026-10-02. History back to 2016-07-01.
- Current rates
- 20,899
- Services
- 83
- Programs
- 6
- Lines with a plan rule
- 0of 19 service lines
By industry
Applied behavior analysis (ABA)Georgia rates, labor costs and changesBehavioral healthGeorgia rates, labor costs and changesHome healthGeorgia rates, labor costs and changesHome care & personal careGeorgia rates, labor costs and changesPrivate duty nursingGeorgia rates, labor costs and changesSkilled nursing facilitiesGeorgia rates, labor costs and changesHospiceGeorgia rates, labor costs and changesIntellectual & developmental disabilitiesGeorgia rates, labor costs and changesOutpatient therapy (PT, OT, speech)Georgia rates, labor costs and changes
Georgia rates by service
The median current rate for each service, like-for-like by unit. Follow a service to compare it with every other state.
| Service | Line | Median rate | Unit | Per hour | Variants |
|---|---|---|---|---|---|
| ABA assessment by a behavior analyst | ABA / autism services | $40.14 | 15 min | $160.56 | 9 |
| ABA assessment support by a technician | ABA / autism services | $30.91 | 15 min | $123.64 | 15 |
| ABA assessment with 2+ technicians (severe behavior) | ABA / autism services | $30.91 | 15 min | $123.64 | 15 |
| ABA parent and caregiver training | ABA / autism services | $17.52 | 15 min | $70.08 | 9 |
| ABA therapy with 2+ technicians (severe behavior) | ABA / autism services | $30.91 | 15 min | $123.64 | 15 |
| ABA therapy with plan changes by an analyst | ABA / autism services | $40.14 | 15 min | $160.56 | 9 |
| Group ABA parent training (several families) | ABA / autism services | $17.51 | 15 min | $70.04 | 9 |
| Group ABA therapy led by a technician | ABA / autism services | $30.91 | 15 min | $123.64 | 15 |
| Group ABA therapy led by an analyst | ABA / autism services | $17.51 | 15 min | $70.04 | 9 |
| One-on-one ABA therapy by a technician | ABA / autism services | $30.91 | 15 min | $123.64 | 15 |
| Behavioral health aide | Behavioral health | $6.63 | 15 min | $26.52 | 1 |
| Mental health counseling | Behavioral health | $24.91 | per unit | — | 4 |
| Outpatient psychotherapy and diagnostic evaluation | Behavioral health | $80.14 | — | $88.54 | 22 |
| Therapeutic behavioral services | Behavioral health | $22.34 | 15 min | $89.36 | 2 |
| Dental services | Dental | $105.37 | — | — | 154 |
| Durable medical equipment | Equipment & supplies | $91.67 | — | $42.92 | 768 |
| Enteral and parenteral nutrition | Equipment & supplies | $4.00 | — | — | 45 |
| Medical supplies | Equipment & supplies | $7.46 | — | — | 187 |
| Orthotics and prosthetics | Equipment & supplies | $307.38 | — | $64.66 | 734 |
| Adult day health (medical model) | Other home & community services | $74.36 | day | — | 4 |
| Adult day services | Other home & community services | $81.13 | day | — | 4 |
| Assisted living / alternative living services | Other home & community services | $80.23 | day | — | 4 |
| Assistive technology assessment | Other home & community services | $38.66 | 15 min | $154.64 | 2 |
| Case management / support coordination | Other home & community services | $72.60 | — | $25.00 | 15 |
| Emergency response system installation | Other home & community services | $121.11 | — | — | 3 |
| Emergency response system monitoring | Other home & community services | $40.36 | month | — | 4 |
| Financial management services (self-direction) | Other home & community services | $95.00 | per unit | — | 2 |
| Home modifications (accessibility) | Other home & community services | $8,000.00 | — | — | 2 |
| Home-delivered meals | Other home & community services | $8.15 | meal | — | 1 |
| Interpreter services | Other home & community services | $26.76 | 15 min | $107.04 | 2 |
| Respite care (daily) | Other home & community services | $184.72 | day | — | 25 |
| Respite care (hourly) | Other home & community services | $5.77 | per unit | $23.08 | 34 |
| Self-direction coaching / supports broker | Other home & community services | $9.25 | 15 min | $37.00 | 2 |
| Specialized medical equipment and supplies | Other home & community services | $1,134.24 | month | — | 2 |
| Vehicle modifications | Other home & community services | $247.50 | — | — | 2 |
| Home health nurse visit (RN or LPN) | Home health | $63.41 | visit | — | 9 |
| Hospice continuous home care (hourly) | Hospice | $62.40 | hour | $62.40 | 22 |
| Hospice end-of-life visit add-on (per hour) | Hospice | $36.84 | hour | $62.40 | 44 |
| Hospice general inpatient care (daily) | Hospice | $1,092.55 | day | — | 22 |
| Hospice inpatient respite (daily) | Hospice | $512.35 | day | — | 22 |
| Hospice routine home care (daily) | Hospice | $188.47 | day | — | 44 |
| Inpatient DRG pricing input (outlier, cost ratio, stay) | Hospital inpatient | $44,020.50 | ratio | — | 1464 |
| Inpatient DRG relative weight | Hospital inpatient | $1.51 | weight | — | 1332 |
| Inpatient hospital stay (DRG base rate) | Hospital inpatient | $6,373.78 | discharge | — | 132 |
| Additional residential staffing | IDD services | $8.50 | 15 min | $34.00 | 2 |
| Behavior support services (disability waiver) | IDD services | $24.36 | 15 min | $97.44 | 6 |
| Community integration / community access (IDD) | IDD services | $4.89 | — | $19.54 | 40 |
| In-home and community living supports (IDD) | IDD services | $5.49 | 15 min | $21.96 | 42 |
| Prevocational services | IDD services | $3.48 | 15 min | $13.92 | 4 |
| Residential habilitation / group home supports | IDD services | $323.26 | 1 Day | — | 19 |
| Supported employment (job coaching) | IDD services | $7.37 | 15 min | $29.46 | 36 |
| Clinical lab tests | Lab & pathology | $21.69 | — | — | 1694 |
| Nursing home bed-hold (leave) day | Nursing facility | $195.55 | day | — | 356 |
| Nursing home stay (daily rate) | Nursing facility | $277.70 | day | — | 356 |
| Home health aide or nurse aide care (hourly) | Personal care & attendant | $6.38 | 15 min | $25.52 | 2 |
| Personal assistance retainer payment | Personal care & attendant | $9.28 | 15 min | $37.12 | 7 |
| Personal care / attendant care (hourly) | Personal care & attendant | $25.53 | 15 min | $25.53 | 8 |
| Structured family caregiving (daily) | Personal care & attendant | $110.39 | day | — | 1 |
| Training for unpaid family caregivers | Personal care & attendant | $21.52 | — | — | 2 |
| Physician-administered drugs (J-codes) | Pharmacy | $27.81 | — | — | 810 |
| Private duty nursing (hourly shifts) | Private duty nursing | $19.85 | 15 min | $79.38 | 6 |
| Waiver nursing (RN or LPN, by the 15 minutes) | Private duty nursing | $24.36 | 15 min | $97.44 | 7 |
| Anesthesia base units (per procedure) | Physician & professional | $5.00 | base unit | — | 280 |
| Anesthesia conversion factor | Physician & professional | $13.13 | unit | — | 6 |
| Physician and practitioner services (fee schedule) | Physician & professional | $264.01 | — | $85.19 | 9811 |
| Imaging and radiology | Radiology | $67.47 | — | — | 1906 |
| Cognitive rehabilitation therapy | Therapy (PT/OT/speech) | $20.15 | 15 min | $80.60 | 12 |
| Nutrition counseling (dietitian) | Therapy (PT/OT/speech) | $26.02 | 15 min | $112.36 | 8 |
| Occupational therapy | Therapy (PT/OT/speech) | $30.23 | 15 min | $120.92 | 33 |
| Occupational therapy evaluation | Therapy (PT/OT/speech) | $71.98 | — | — | 31 |
| Orthotic and prosthetic fitting and training | Therapy (PT/OT/speech) | $30.23 | 15 min | $120.92 | 29 |
| Physical therapy | Therapy (PT/OT/speech) | $29.65 | 15 min | $116.28 | 16 |
| Physical therapy evaluation | Therapy (PT/OT/speech) | $74.27 | — | — | 32 |
| Speech-generating device evaluation | Therapy (PT/OT/speech) | $117.03 | — | — | 6 |
| Speech-generating device therapy | Therapy (PT/OT/speech) | $58.64 | — | — | 7 |
| Speech-language evaluation | Therapy (PT/OT/speech) | $113.99 | — | — | 16 |
| Speech-language therapy | Therapy (PT/OT/speech) | $65.64 | — | — | 11 |
| Swallowing and feeding evaluation | Therapy (PT/OT/speech) | $125.89 | — | — | 7 |
| Swallowing and feeding therapy | Therapy (PT/OT/speech) | $47.83 | — | — | 6 |
| Ambulance mileage | Transportation | $2.46 | mile | — | 2 |
| Ground ambulance transport | Transportation | $303.67 | — | — | 7 |
| Eyeglasses and contact lenses | Vision & hearing | $263.86 | — | — | 7 |
| Hearing aids and hearing services | Vision & hearing | $1,325.50 | — | — | 32 |
Most-compared billing codes in Georgia
Where Georgia ranks among states for codes published widely. Rank 1 = highest rate.
| Code | Service | Georgia | All-state median | Rank |
|---|---|---|---|---|
| 10004 | Physician and practitioner services (fee schedule) | $38.39 | $35.52 | 6 of 19 |
| 10005 | Physician and practitioner services (fee schedule) | $64.41 | $60.63 | 8 of 19 |
| 10006 | Physician and practitioner services (fee schedule) | $43.86 | $39.90 | 6 of 19 |
| 10007 | Physician and practitioner services (fee schedule) | $82.81 | $76.74 | 7 of 19 |
| 10008 | Physician and practitioner services (fee schedule) | $53.97 | $46.94 | 6 of 19 |
| 10009 | Physician and practitioner services (fee schedule) | $100.27 | $93.03 | 7 of 19 |
| 10010 | Physician and practitioner services (fee schedule) | $73.29 | $65.32 | 6 of 19 |
| 10021 | Physician and practitioner services (fee schedule) | $83.46 | $49.77 | 2 of 19 |
| 10030 | Physician and practitioner services (fee schedule) | $134.94 | $119.43 | 5 of 19 |
| 10035 | Physician and practitioner services (fee schedule) | $75.57 | $70.26 | 7 of 19 |
| 10036 | Physician and practitioner services (fee schedule) | $38.08 | $35.41 | 8 of 19 |
| 10060 | Physician and practitioner services (fee schedule) | $52.62 | $76.16 | 17 of 19 |
| 10061 | Physician and practitioner services (fee schedule) | $102.96 | $129.16 | 15 of 19 |
| 10080 | Physician and practitioner services (fee schedule) | $54.51 | $78.73 | 14 of 19 |
| 10081 | Physician and practitioner services (fee schedule) | $117.21 | $127.86 | 13 of 19 |
| 10120 | Physician and practitioner services (fee schedule) | $56.04 | $77.44 | 16 of 19 |
| 10121 | Physician and practitioner services (fee schedule) | $127.79 | $135.29 | 12 of 19 |
| 10140 | Physician and practitioner services (fee schedule) | $68.25 | $86.45 | 15 of 19 |
| 10160 | Physician and practitioner services (fee schedule) | $55.13 | $69.52 | 14 of 19 |
| 10180 | Physician and practitioner services (fee schedule) | $115.08 | $148.10 | 15 of 19 |
| 11000 | Physician and practitioner services (fee schedule) | $27.25 | $24.52 | 6 of 19 |
| 11001 | Physician and practitioner services (fee schedule) | $14.11 | $12.36 | 6 of 19 |
| 11004 | Physician and practitioner services (fee schedule) | $488.50 | $437.21 | 5 of 19 |
| 11005 | Physician and practitioner services (fee schedule) | $665.92 | $573.02 | 4 of 19 |
| 11006 | Physician and practitioner services (fee schedule) | $614.50 | $542.16 | 5 of 19 |
| 11008 | Physician and practitioner services (fee schedule) | $250.17 | $206.56 | 3 of 19 |
| 11010 | Physician and practitioner services (fee schedule) | $243.78 | $225.24 | 8 of 19 |
| 11011 | Physician and practitioner services (fee schedule) | $291.85 | $229.46 | 3 of 19 |
| 11012 | Physician and practitioner services (fee schedule) | $414.55 | $326.26 | 3 of 19 |
| 11042 | Physician and practitioner services (fee schedule) | $50.39 | $50.80 | 11 of 19 |
| 11043 | Physician and practitioner services (fee schedule) | $134.21 | $134.21 | 10 of 19 |
| 11044 | Physician and practitioner services (fee schedule) | $182.12 | $182.12 | 10 of 19 |
| 11055 | Physician and practitioner services (fee schedule) | $13.17 | $14.80 | 12 of 19 |
| 11056 | Physician and practitioner services (fee schedule) | $18.50 | $20.38 | 11 of 19 |
| 11057 | Physician and practitioner services (fee schedule) | $22.25 | $26.13 | 12 of 19 |
| 11102 | Physician and practitioner services (fee schedule) | $34.98 | $32.23 | 7 of 19 |
| 11103 | Physician and practitioner services (fee schedule) | $20.25 | $18.65 | 7 of 19 |
| 11104 | Physician and practitioner services (fee schedule) | $43.87 | $40.43 | 7 of 19 |
| 11105 | Physician and practitioner services (fee schedule) | $23.93 | $22.05 | 7 of 19 |
| 11106 | Physician and practitioner services (fee schedule) | $53.40 | $49.21 | 7 of 19 |
Managed care in Georgia
14 plans on record, 0 state-directed payment records, 178 published capitation cells.
Who sets the rate, line by line →Recent rate changes and notices
Frequently asked questions
Where does Georgia publish its Medicaid fee schedules?
Georgia publishes rates across 217 official documents (fee schedules, rate notices and bulletins). Every rate on this page links to its source document.
How many Medicaid rates does Georgia publish?
20,899 rates are current across 83 services and 6 programs, with 52,541 versions on record since 2016-07-01.
Do Georgia Medicaid managed-care plans pay the fee schedule?
For 0 of 19 service lines, plan contracts or state law set a rule plans must follow (a floor, a state-set rate or a required pass-through). For the rest, plans negotiate. See the managed-care page for each line's rule and citation.
Other states
Your Georgia rate cardYour codes, what Georgia pays, what plans must pay, and every change in 2026.