Iowa Medicaid reimbursement rates
105,138 current fee-for-service and managed-care rates from Iowa Medicaid, across 110 services and 13 programs, normalized by code, provider level and unit. Each links to one of 90 official source documents.
Last retrieved 2026-10-05. History back to 2005-07-01.
- Current rates
- 105,138
- Services
- 110
- Programs
- 13
- Lines with a plan rule
- 19of 21 service lines
By industry
Applied behavior analysis (ABA)Iowa rates, labor costs and changesBehavioral healthIowa rates, labor costs and changesHome healthIowa rates, labor costs and changesHome care & personal careIowa rates, labor costs and changesPrivate duty nursingIowa rates, labor costs and changesSkilled nursing facilitiesIowa rates, labor costs and changesHospiceIowa rates, labor costs and changesIntellectual & developmental disabilitiesIowa rates, labor costs and changesOutpatient therapy (PT, OT, speech)Iowa rates, labor costs and changes
Iowa 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 | $35.73 | 15 min | $142.92 | 2 |
| ABA assessment support by a technician | ABA / autism services | $35.73 | 15 min | $142.92 | 3 |
| ABA parent and caregiver training | ABA / autism services | $21.60 | 15 min | $86.40 | 6 |
| ABA therapy with plan changes by an analyst | ABA / autism services | $36.81 | 15 min | $147.24 | 2 |
| Group ABA parent training (several families) | ABA / autism services | $8.65 | 15 min | $34.58 | 2 |
| Group ABA therapy led by a technician | ABA / autism services | $28.59 | 15 min | $114.36 | 3 |
| Group ABA therapy led by an analyst | ABA / autism services | $8.65 | 15 min | $34.58 | 2 |
| One-on-one ABA therapy by a technician | ABA / autism services | $28.59 | 15 min | $114.36 | 3 |
| Behavioral health services (fee schedule) | Behavioral health | $46.06 | — | $90.68 | 145 |
| Family support (behavioral health) | Behavioral health | $10.43 | 15 min | $41.72 | 1 |
| Intensive home-based treatment (IHBT) | Behavioral health | $27.92 | 15 min | $111.68 | 1 |
| Mental health assessment (non-physician) | Behavioral health | $125.00 | — | — | 43 |
| Mental health counseling | Behavioral health | $18.00 | — | $51.48 | 11 |
| Mental health service plan development | Behavioral health | $31.25 | — | — | 4 |
| Multisystemic therapy for youth | Behavioral health | $46.37 | 15 min | $185.48 | 3 |
| Outpatient psychotherapy and diagnostic evaluation | Behavioral health | $85.00 | — | $133.15 | 1932 |
| Psychosocial rehabilitation | Behavioral health | $38.33 | 15 min | $15.00 | 2 |
| Residential support for independent living (BH HCBS) | Behavioral health | $236.99 | day | — | 7 |
| Skills training and development | Behavioral health | $21.59 | 15 min | $86.36 | 15 |
| Supported employment (behavioral health) | Behavioral health | $3,692.34 | Monthly Limit | — | 13 |
| Therapeutic behavioral services | Behavioral health | $25.84 | 15 min | $103.36 | 18 |
| Dental services | Dental | $160.33 | — | $119.14 | 1033 |
| Durable medical equipment | Equipment & supplies | $119.88 | — | $39.32 | 1787 |
| Enteral and parenteral nutrition | Equipment & supplies | $30.90 | — | — | 80 |
| Medical supplies | Equipment & supplies | $15.52 | — | — | 1280 |
| Orthotics and prosthetics | Equipment & supplies | $220.59 | — | $69.44 | 2450 |
| Adult day health (medical model) | Other home & community services | $10.07 | 15 min | $40.28 | 4 |
| Adult day services | Other home & community services | $35.14 | 15 min | $24.56 | 29 |
| Assisted living / alternative living services | Other home & community services | $31.43 | day | — | 1 |
| Assistive technology assessment | Other home & community services | $442.43 | Per Assessment | — | 2 |
| Case management / support coordination | Other home & community services | $30.00 | 15 min | $120.00 | 17 |
| Chore services (heavy cleaning, yard work, pest control) | Other home & community services | $6.55 | 15 min | $26.20 | 3 |
| Emergency response system installation | Other home & community services | $58.48 | Initial One-Time | — | 10 |
| Emergency response system monitoring | Other home & community services | $45.48 | Ongoing Monthly Fee | — | 10 |
| Family caregiver training and support | Other home & community services | $12.86 | 15 min | $51.44 | 1 |
| Financial management services (self-direction) | Other home & community services | $77.51 | Per Member Per Month | — | 6 |
| HCBS cost cap or rate limit | Other home & community services | $2,274.96 | month | — | 9 |
| HCBS waiver service (other) | Other home & community services | $10.43 | 15 min | $41.72 | 3 |
| Home modifications (accessibility) | Other home & community services | $7,154.64 | Lifetime Maximum | — | 11 |
| Home-delivered meals | Other home & community services | $9.11 | meal | — | 12 |
| Interpreter services | Other home & community services | $14.39 | 15 min | $57.56 | 52 |
| Nursing assessment | Other home & community services | $143.31 | — | — | 5 |
| Positive behavioral interventions and support | Other home & community services | $12.87 | 15 min | $51.48 | 1 |
| Prescribed pediatric extended care (medical day care) | Other home & community services | $23.95 | hour | $23.95 | 1 |
| Respite care (daily) | Other home & community services | $356.93 | Daily Limit | — | 66 |
| Respite care (hourly) | Other home & community services | $5.41 | 15 min | $21.64 | 66 |
| Respite in a facility (daily) | Other home & community services | $180.44 | 15 min | $15.76 | 96 |
| Self-directed (consumer choices) budget-calculation rate | Other home & community services | $7.11 | — | — | 148 |
| Self-direction coaching / supports broker | Other home & community services | $18.06 | hour | $18.06 | 6 |
| Social work services (waiver) | Other home & community services | $66.83 | day | — | 2 |
| Specialized medical equipment and supplies | Other home & community services | $7,154.64 | Per Unit | — | 7 |
| Vehicle modifications | Other home & community services | $7,154.64 | Lifetime Maximum | — | 5 |
| Home health aide visit | Home health | $62.47 | — | — | 51 |
| Home health nurse visit (RN or LPN) | Home health | $150.09 | — | $98.87 | 91 |
| Home health occupational therapy | Home health | $147.92 | — | — | 35 |
| Home health physical therapy | Home health | $146.92 | — | — | 35 |
| Home health speech therapy | Home health | $159.71 | — | — | 35 |
| Hospice routine home care (daily) | Hospice | $210.64 | day | — | 113 |
| Inpatient DRG relative weight | Hospital inpatient | $1.31 | — | — | 771 |
| Outpatient hospital APC relative weight | Hospital outpatient | $36.57 | — | $91.24 | 11104 |
| Surgery center facility fee (per procedure) | Hospital outpatient | $429.27 | — | — | 4 |
| Day habilitation / day program (IDD) | IDD services | $91.89 | 15 min | $15.88 | 7 |
| Employment exploration | IDD services | $43.00 | hour | $43.00 | 3 |
| ICF/IID stay (daily rate) | IDD services | $503.46 | — | — | 1 |
| In-home and community living supports (IDD) | IDD services | $11.59 | 15 min | $46.36 | 2 |
| Job development and self-employment outcome payments | IDD services | $1,982.48 | day | — | 4 |
| Prevocational services | IDD services | $11.24 | hour | $11.24 | 3 |
| Remote supports (technology-based supervision) | IDD services | $4,500.00 | Per Member Annual Limit | — | 6 |
| Residential habilitation / group home supports | IDD services | $306.52 | day | — | 18 |
| Supported employment (job coaching) | IDD services | $79.82 | Monthly Limit | $79.82 | 20 |
| Supported employment follow-along | IDD services | $1,362.84 | Monthly Limit | $54.51 | 25 |
| Clinical lab tests | Lab & pathology | $18.73 | — | — | 9454 |
| Nursing home stay (daily rate) | Nursing facility | $278.28 | day | — | 772 |
| Nursing home ventilator care (daily rate) | Nursing facility | $701.37 | day | — | 387 |
| Early intervention services for infants and toddlers | Other | $15.42 | 30 min | $33.11 | 11 |
| Managed care capitation rate | Other | $19.90 | month | — | 72 |
| School-based Medicaid service (billed by a school district) | Other | $20.95 | — | $63.54 | 53 |
| Companion care | Personal care & attendant | $2.12 | 15 min | $8.48 | 1 |
| Personal care (daily rate) | Personal care & attendant | $294.00 | day | — | 1 |
| Personal care / attendant care (hourly) | Personal care & attendant | $10.50 | 15 min | $28.92 | 25 |
| Pharmacy dispensing fee | Pharmacy | $10.63 | — | — | 1 |
| Physician-administered drugs (J-codes) | Pharmacy | $13.82 | — | — | 4986 |
| Nurse shadowing / home care training | Private duty nursing | $25.00 | 15 min | $100.00 | 18 |
| Private duty nursing (hourly shifts) | Private duty nursing | $92.50 | hour | $92.50 | 26 |
| Waiver nursing (RN or LPN, by the 15 minutes) | Private duty nursing | $19.95 | 15 min | $79.80 | 6 |
| Physician and practitioner services (fee schedule) | Physician & professional | $242.03 | — | $72.36 | 56988 |
| Imaging and radiology | Radiology | $66.30 | — | — | 9548 |
| Cognitive rehabilitation therapy | Therapy (PT/OT/speech) | $25.99 | 15 min | $103.96 | 8 |
| Nutrition counseling (dietitian) | Therapy (PT/OT/speech) | $13.97 | 15 min | $55.88 | 37 |
| Occupational therapy | Therapy (PT/OT/speech) | $21.72 | 15 min | $86.86 | 26 |
| Occupational therapy evaluation | Therapy (PT/OT/speech) | $71.17 | — | — | 40 |
| Orthotic and prosthetic fitting and training | Therapy (PT/OT/speech) | $24.33 | 15 min | $97.30 | 32 |
| Other therapy services | Therapy (PT/OT/speech) | $12.00 | — | — | 9 |
| Physical therapy | Therapy (PT/OT/speech) | $22.65 | 15 min | $90.60 | 17 |
| Physical therapy evaluation | Therapy (PT/OT/speech) | $73.33 | — | — | 36 |
| Speech-generating device evaluation | Therapy (PT/OT/speech) | $89.36 | — | — | 7 |
| Speech-generating device therapy | Therapy (PT/OT/speech) | $48.35 | — | — | 7 |
| Speech-language evaluation | Therapy (PT/OT/speech) | $87.69 | — | — | 40 |
| Speech-language therapy | Therapy (PT/OT/speech) | $76.38 | — | — | 11 |
| Swallowing and feeding evaluation | Therapy (PT/OT/speech) | $92.04 | — | — | 15 |
| Swallowing and feeding therapy | Therapy (PT/OT/speech) | $46.75 | — | — | 8 |
| Air ambulance transport | Transportation | $550.00 | — | — | 3 |
| Ambulance mileage | Transportation | $5.99 | mile | — | 4 |
| Ground ambulance transport | Transportation | $101.60 | — | — | 25 |
| Non-emergency medical transportation (NEMT) | Transportation | $11.48 | mile | — | 4 |
| Waiver transportation (to community activities) | Transportation | $3.11 | per loaded mile | — | 52 |
| Eye exams and vision services | Vision & hearing | $29.33 | 15 min | $119.14 | 3 |
| Eyeglasses and contact lenses | Vision & hearing | $25.54 | — | — | 611 |
| Hearing aids and hearing services | Vision & hearing | $228.88 | — | — | 42 |
| Hearing tests and audiology services | Vision & hearing | $40.73 | — | — | 3 |
Most-compared billing codes in Iowa
Where Iowa ranks among states for codes published widely. Rank 1 = highest rate.
| Code | Service | Iowa | All-state median | Rank |
|---|---|---|---|---|
| 10005 | Physician and practitioner services (fee schedule) | $83.28 | $79.38 | 16 of 35 |
| 10006 | Physician and practitioner services (fee schedule) | $83.28 | $44.97 | 2 of 35 |
| 10007 | Physician and practitioner services (fee schedule) | $83.28 | $150.61 | 22 of 35 |
| 10008 | Physician and practitioner services (fee schedule) | $83.28 | $73.48 | 16 of 35 |
| 10009 | Physician and practitioner services (fee schedule) | $83.28 | $180.34 | 29 of 35 |
| 10010 | Physician and practitioner services (fee schedule) | $83.28 | $102.56 | 20 of 35 |
| 10021 | Physician and practitioner services (fee schedule) | $80.80 | $67.99 | 12 of 35 |
| 10030 | Physician and practitioner services (fee schedule) | $683.93 | $162.47 | 2 of 35 |
| 10060 | Physician and practitioner services (fee schedule) | $70.84 | $81.94 | 22 of 35 |
| 10061 | Physician and practitioner services (fee schedule) | $130.01 | $148.21 | 22 of 35 |
| 10080 | Physician and practitioner services (fee schedule) | $83.30 | $100.82 | 21 of 35 |
| 10081 | Physician and practitioner services (fee schedule) | $153.56 | $159.09 | 20 of 35 |
| 10120 | Physician and practitioner services (fee schedule) | $80.78 | $89.53 | 21 of 35 |
| 10121 | Physician and practitioner services (fee schedule) | $160.00 | $159.38 | 17 of 35 |
| 10140 | Physician and practitioner services (fee schedule) | $85.74 | $100.20 | 24 of 35 |
| 10160 | Physician and practitioner services (fee schedule) | $74.37 | $79.28 | 20 of 35 |
| 10180 | Physician and practitioner services (fee schedule) | $124.07 | $154.29 | 28 of 35 |
| 11000 | Physician and practitioner services (fee schedule) | $37.40 | $35.27 | 15 of 35 |
| 11001 | Physician and practitioner services (fee schedule) | $20.30 | $16.01 | 13 of 35 |
| 11004 | Physician and practitioner services (fee schedule) | $533.09 | $437.26 | 5 of 35 |
| 11005 | Physician and practitioner services (fee schedule) | $724.27 | $593.90 | 4 of 35 |
| 11006 | Physician and practitioner services (fee schedule) | $664.91 | $548.28 | 5 of 35 |
| 11008 | Physician and practitioner services (fee schedule) | $269.12 | $211.81 | 4 of 35 |
| 11010 | Physician and practitioner services (fee schedule) | $263.64 | $259.67 | 17 of 35 |
| 11011 | Physician and practitioner services (fee schedule) | $325.88 | $291.14 | 14 of 35 |
| 11012 | Physician and practitioner services (fee schedule) | $450.04 | $393.77 | 12 of 35 |
| 11042 | Physician and practitioner services (fee schedule) | $66.43 | $76.21 | 19 of 35 |
| 11043 | Physician and practitioner services (fee schedule) | $158.67 | $158.67 | 18 of 35 |
| 11044 | Physician and practitioner services (fee schedule) | $213.31 | $213.31 | 18 of 35 |
| 11055 | Physician and practitioner services (fee schedule) | $19.90 | $20.00 | 19 of 35 |
| 11056 | Physician and practitioner services (fee schedule) | $26.58 | $29.68 | 20 of 35 |
| 11057 | Physician and practitioner services (fee schedule) | $29.80 | $38.94 | 23 of 35 |
| 11102 | Physician and practitioner services (fee schedule) | $62.78 | $65.28 | 19 of 35 |
| 11103 | Physician and practitioner services (fee schedule) | $30.91 | $32.73 | 20 of 35 |
| 11104 | Physician and practitioner services (fee schedule) | $62.78 | $77.06 | 21 of 35 |
| 11105 | Physician and practitioner services (fee schedule) | $30.91 | $38.77 | 21 of 35 |
| 11106 | Physician and practitioner services (fee schedule) | $62.78 | $95.36 | 22 of 35 |
| 11107 | Physician and practitioner services (fee schedule) | $30.91 | $46.36 | 23 of 35 |
| 11300 | Physician and practitioner services (fee schedule) | $43.98 | $42.15 | 17 of 35 |
| 11301 | Physician and practitioner services (fee schedule) | $60.30 | $55.47 | 16 of 35 |
Managed care in Iowa
15 plans on record, 0 state-directed payment records, 1,737 published capitation cells.
Who sets the rate, line by line →Recent rate changes and notices
Frequently asked questions
Where does Iowa publish its Medicaid fee schedules?
Iowa publishes rates across 90 official documents (fee schedules, rate notices and bulletins). Every rate on this page links to its source document.
How many Medicaid rates does Iowa publish?
105,138 rates are current across 110 services and 13 programs, with 156,904 versions on record since 2005-07-01.
Do Iowa Medicaid managed-care plans pay the fee schedule?
For 19 of 21 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.
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Your Iowa rate cardYour codes, what Iowa pays, what plans must pay, and every change in 2026.