Ohio Medicaid reimbursement rates
43,217 current fee-for-service and managed-care rates from Ohio Medicaid, across 119 services and 15 programs, normalized by code, provider level and unit. Each links to one of 134 official source documents.
Last retrieved 2026-10-02. History back to 1985-01-01.
- Current rates
- 43,217
- Services
- 119
- Programs
- 15
- Lines with a plan rule
- 6of 19 service lines
By industry
Applied behavior analysis (ABA)Ohio rates, labor costs and changesBehavioral healthOhio rates, labor costs and changesHome healthOhio rates, labor costs and changesHome care & personal careOhio rates, labor costs and changesPrivate duty nursingOhio rates, labor costs and changesSkilled nursing facilitiesOhio rates, labor costs and changesHospiceOhio rates, labor costs and changesIntellectual & developmental disabilitiesOhio rates, labor costs and changesOutpatient therapy (PT, OT, speech)Ohio rates, labor costs and changes
Ohio 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 |
|---|---|---|---|---|---|
| Addiction (substance use) counseling | Behavioral health | $10.56 | 15 min | $42.24 | 36 |
| Ambulatory withdrawal management (detox) | Behavioral health | $269.38 | day | $127.68 | 12 |
| Assertive Community Treatment (ACT) team | Behavioral health | $284.03 | day | — | 48 |
| Behavioral health nursing (RN/LPN) | Behavioral health | $32.84 | 15 min | $131.36 | 33 |
| Behavioral health services (fee schedule) | Behavioral health | $85.00 | per cent | — | 5 |
| Community psychiatric support and treatment (CPST) | Behavioral health | $14.84 | 15 min | $59.36 | 48 |
| Functional family therapy (FFT) | Behavioral health | $38.92 | 15 min | $155.66 | 2 |
| Hospital outpatient mental health program services | Behavioral health | $26.21 | — | — | 2 |
| Intensive home-based treatment (IHBT) | Behavioral health | $40.47 | 15 min | $161.86 | 4 |
| Intensive outpatient program (behavioral health) | Behavioral health | $133.03 | day | — | 6 |
| Medically supervised inpatient withdrawal (per day) | Behavioral health | $340.94 | day | — | 6 |
| Medication administration (behavioral health) | Behavioral health | $258.56 | day | — | 40 |
| Mental health assessment (non-physician) | Behavioral health | $185.75 | — | — | 56 |
| Mental health counseling | Behavioral health | $21.21 | — | — | 1 |
| Mobile and telephone crisis response | Behavioral health | $141.22 | 15 min | $141.22 | 94 |
| Multisystemic therapy for youth | Behavioral health | $46.99 | 15 min | $187.94 | 2 |
| Opioid treatment: methadone administration | Behavioral health | $258.56 | day | — | 40 |
| Outpatient psychotherapy and diagnostic evaluation | Behavioral health | $78.63 | encounter | $164.55 | 428 |
| Peer support (behavioral health) | Behavioral health | $15.51 | 15 min | $62.04 | 11 |
| Psychiatric partial hospitalization | Behavioral health | $213.88 | day | — | 4 |
| Psychiatric residential treatment (daily) | Behavioral health | $1,064.58 | day | — | 4 |
| Psychological and developmental testing | Behavioral health | $63.26 | hour | $66.82 | 132 |
| Psychosocial rehabilitation | Behavioral health | $23.07 | 15 min | $92.26 | 28 |
| Screening, brief intervention and referral (SBIRT) | Behavioral health | $40.01 | encounter | — | 38 |
| SUD case management | Behavioral health | $22.03 | 15 min | $88.12 | 23 |
| SUD drug testing (collection and handling) | Behavioral health | $16.33 | encounter | — | 31 |
| SUD residential treatment (per day) | Behavioral health | $240.95 | day | — | 8 |
| Supported employment (behavioral health) | Behavioral health | $22.02 | 15 min | $88.08 | 4 |
| Therapeutic behavioral services | Behavioral health | $32.24 | hour | $114.84 | 112 |
| Therapeutic behavioral services (daily rate) | Behavioral health | $162.41 | day | — | 8 |
| Dental payment adjustment (percent of the fee schedule) | Dental | $105.00 | one hundred five per cent of the amount listed in appendix DD | — | 1 |
| Dental services | Dental | $140.00 | — | — | 207 |
| Durable medical equipment | Equipment & supplies | $417.47 | — | — | 805 |
| Enteral and parenteral nutrition | Equipment & supplies | $2.50 | Each | — | 48 |
| Medical supplies | Equipment & supplies | $8.94 | Each | — | 679 |
| Orthotics and prosthetics | Equipment & supplies | $329.65 | — | — | 931 |
| Adult day services | Other home & community services | $40.48 | Per half day | $11.74 | 11 |
| Assisted living / alternative living services | Other home & community services | $137.50 | day | — | 4 |
| Assistive technology assessment | Other home & community services | $137.44 | Outcome based (written recommendation required for payment) | — | 6 |
| Assistive technology support (training and set-up) | Other home & community services | $5.45 | Fifteen-minute billing unit | — | 6 |
| Case management / support coordination | Other home & community services | $27.54 | month | $42.24 | 7 |
| Community integration (older adults / disability waivers) | Other home & community services | $3.93 | Per fifteen-minute unit | $15.72 | 2 |
| Community transition (moving out of an institution) | Other home & community services | $2,000.00 | Per job; $2,000 per waiver enrollment | — | 3 |
| Emergency response system installation | Other home & community services | $32.95 | Per installation and testing | — | 2 |
| Emergency response system monitoring | Other home & community services | $32.95 | Per monthly fee | — | 2 |
| Health care assessment (monthly, disability waiver) | Other home & community services | $34.50 | Calendar month | — | 3 |
| Home-delivered meals | Other home & community services | $10.61 | meal | — | 16 |
| Interpreter services | Other home & community services | $14.08 | Fifteen minutes | — | 64 |
| Money management support | Other home & community services | $7.87 | Fifteen minutes | — | 32 |
| Nursing assessment | Other home & community services | $33.57 | Per assessment | $35.32 | 12 |
| Respite care (daily) | Other home & community services | $197.89 | Partial day | — | 210 |
| Respite care (hourly) | Other home & community services | $3.64 | Fifteen minutes | — | 112 |
| Respite in a facility (daily) | Other home & community services | $304.44 | Daily, based on a twenty-four-hour period during which service is provided. | — | 7 |
| Self-direction coaching / supports broker | Other home & community services | $7.83 | Fifteen-minute billing unit | — | 6 |
| Social work services (waiver) | Other home & community services | $13.96 | Fifteen minutes | $65.04 | 65 |
| Specialized medical equipment and supplies | Other home & community services | $5,224.93 | 1 item | — | 2 |
| Home health aide visit | Home health | $21.22 | visit | $16.64 | 2 |
| Home health nurse visit (RN or LPN) | Home health | $37.90 | visit | $31.28 | 11 |
| Home health occupational therapy | Home health | $39.49 | visit | $19.08 | 2 |
| Home health physical therapy | Home health | $39.49 | visit | $19.08 | 2 |
| Home health speech therapy | Home health | $39.49 | visit | $19.08 | 2 |
| Inpatient capital payment (building and equipment) | Hospital inpatient | $390.17 | — | — | 424 |
| Inpatient DRG pricing input (outlier, cost ratio, stay) | Hospital inpatient | $0.20 | — | — | 725 |
| Inpatient DRG relative weight | Hospital inpatient | $1.39 | — | — | 1412 |
| Inpatient hospital stay (DRG base rate) | Hospital inpatient | $6,132.92 | — | — | 466 |
| Inpatient psychiatric stay (per day) | Hospital inpatient | $0.00 | day | — | 462 |
| Inpatient rate add-on (education, wage, directed payment) | Hospital inpatient | $0.00 | — | — | 456 |
| EAPG relative weight (outpatient hospital or surgery center) | Hospital outpatient | $1.85 | — | — | 1133 |
| Outpatient hospital add-on payment | Hospital outpatient | $41.29 | — | — | 239 |
| Outpatient hospital conversion factor (APC/EAPG) | Hospital outpatient | $124.20 | — | — | 473 |
| Outpatient hospital payment method | Hospital outpatient | $0.19 | — | — | 727 |
| Behavior support services (disability waiver) | IDD services | $59.84 | hour | $59.84 | 12 |
| Benefits counseling | IDD services | $471.00 | Outcome-based (report required for payment) | — | 6 |
| Day habilitation / day program (IDD) | IDD services | $6.79 | Fifteen minutes | — | 1758 |
| Employment exploration | IDD services | $1,556.95 | Outcome-based (report required for payment) | — | 42 |
| Prevocational services | IDD services | $6.93 | day | — | 1110 |
| Remote supports (technology-based supervision) | IDD services | $2.95 | Fifteen-minute billing unit per site | — | 6 |
| Shared living / host home / family model | IDD services | $213.91 | day | — | 144 |
| Supported employment (job coaching) | IDD services | $37.50 | — | — | 282 |
| Supported employment follow-along | IDD services | $230.00 | — | — | 24 |
| Clinical lab tests | Lab & pathology | $16.37 | — | — | 1882 |
| Nursing home daily add-on (ventilator, trach, insurance) | Nursing facility | $0.00 | — | — | 9199 |
| Nursing home daily rate component (facility-specific) | Nursing facility | $39.77 | — | — | 3660 |
| Nursing home stay (daily rate) | Nursing facility | $278.44 | day | — | 915 |
| Nursing home ventilator care (daily rate) | Nursing facility | $1,225.37 | — | — | 2 |
| Dialysis facility composite rate (per treatment) | Other | $53.02 | per session (printed in the description) | — | 8 |
| Directed payment uniform increase (required MCO uplift) | Other | $163.68 | % increase to base Medicaid payments | — | 6 |
| Directed payment: plan payment level (% of benchmark) | Other | $49.35 | 40% | — | 28 |
| Homemaker / housekeeping help | Personal care & attendant | $5.99 | 15 min | $23.96 | 1 |
| Personal care / attendant care (hourly) | Personal care & attendant | $7.71 | Fifteen minutes | $27.18 | 905 |
| Structured family caregiving (daily) | Personal care & attendant | $77.01 | day | — | 2 |
| Physician-administered drugs (J-codes) | Pharmacy | $17.05 | — | — | 1195 |
| Private duty nursing (hourly shifts) | Private duty nursing | $28.07 | visit | $48.84 | 12 |
| Waiver nursing (RN or LPN, by the 15 minutes) | Private duty nursing | $9.24 | Fifteen minutes | $34.14 | 34 |
| Anesthesia conversion factor | Physician & professional | $16.44 | — | — | 6 |
| Payment percentage for non-physician practitioners | Physician & professional | $85.00 | per cent of the Medicaid maximum (Appendix DD to OAC 5160-1-60) | — | 9 |
| Physician and practitioner services (fee schedule) | Physician & professional | $228.66 | encounter | $73.84 | 9590 |
| Imaging and radiology | Radiology | $115.10 | — | — | 634 |
| Cognitive rehabilitation therapy | Therapy (PT/OT/speech) | $19.15 | 15 min | $76.60 | 7 |
| Nutrition counseling (dietitian) | Therapy (PT/OT/speech) | $16.69 | Fifteen minutes | $75.08 | 79 |
| Occupational therapy | Therapy (PT/OT/speech) | $21.17 | 15 min | $84.66 | 4 |
| Occupational therapy evaluation | Therapy (PT/OT/speech) | $61.31 | — | — | 8 |
| Orthotic and prosthetic fitting and training | Therapy (PT/OT/speech) | $37.80 | 15 min | $151.20 | 6 |
| Physical therapy | Therapy (PT/OT/speech) | $18.71 | 15 min | $74.82 | 4 |
| Physical therapy evaluation | Therapy (PT/OT/speech) | $63.15 | — | — | 8 |
| Speech-generating device evaluation | Therapy (PT/OT/speech) | $81.03 | — | — | 1 |
| Speech-generating device therapy | Therapy (PT/OT/speech) | $52.38 | — | — | 2 |
| Speech-language evaluation | Therapy (PT/OT/speech) | $76.79 | — | — | 8 |
| Speech-language therapy | Therapy (PT/OT/speech) | $57.23 | — | — | 2 |
| Swallowing and feeding evaluation | Therapy (PT/OT/speech) | $50.17 | — | — | 3 |
| Swallowing and feeding therapy | Therapy (PT/OT/speech) | $55.16 | — | — | 2 |
| Air ambulance transport | Transportation | $2,010.00 | — | — | 2 |
| Ambulance extras (waiting time, extra attendant, neonatal) | Transportation | $13.51 | — | — | 2 |
| Ambulance mileage | Transportation | $4.40 | per | — | 4 |
| Ground ambulance transport | Transportation | $267.13 | — | — | 6 |
| Non-emergency medical transportation (NEMT) | Transportation | $15.00 | — | — | 5 |
| Waiver transportation (to community activities) | Transportation | $43.27 | Per one-way trip | — | 345 |
| Eyeglasses and contact lenses | Vision & hearing | $72.03 | — | — | 107 |
| Hearing aids and hearing services | Vision & hearing | $485.00 | Each | — | 95 |
Most-compared billing codes in Ohio
Where Ohio ranks among states for codes published widely. Rank 1 = highest rate.
| Code | Service | Ohio | All-state median | Rank |
|---|---|---|---|---|
| 10004 | Physician and practitioner services (fee schedule) | $35.24 | $35.52 | 11 of 19 |
| 10005 | Physician and practitioner services (fee schedule) | $37.55 | $60.63 | 17 of 19 |
| 10006 | Physician and practitioner services (fee schedule) | $28.02 | $39.90 | 17 of 19 |
| 10007 | Physician and practitioner services (fee schedule) | $46.20 | $76.74 | 18 of 19 |
| 10008 | Physician and practitioner services (fee schedule) | $18.44 | $46.94 | 18 of 19 |
| 10009 | Physician and practitioner services (fee schedule) | $61.49 | $93.03 | 17 of 19 |
| 10010 | Physician and practitioner services (fee schedule) | $40.32 | $65.32 | 17 of 19 |
| 10021 | Physician and practitioner services (fee schedule) | $49.77 | $49.77 | 10 of 19 |
| 10030 | Physician and practitioner services (fee schedule) | $119.43 | $119.43 | 10 of 19 |
| 10035 | Physician and practitioner services (fee schedule) | $70.14 | $70.26 | 11 of 19 |
| 10036 | Physician and practitioner services (fee schedule) | $35.34 | $35.41 | 11 of 19 |
| 10060 | Physician and practitioner services (fee schedule) | $59.75 | $76.16 | 14 of 19 |
| 10061 | Physician and practitioner services (fee schedule) | $93.44 | $129.16 | 16 of 19 |
| 10080 | Physician and practitioner services (fee schedule) | $53.47 | $78.73 | 15 of 19 |
| 10081 | Physician and practitioner services (fee schedule) | $87.38 | $127.86 | 16 of 19 |
| 10120 | Physician and practitioner services (fee schedule) | $52.60 | $77.44 | 17 of 19 |
| 10121 | Physician and practitioner services (fee schedule) | $93.61 | $135.29 | 16 of 19 |
| 10140 | Physician and practitioner services (fee schedule) | $60.04 | $86.45 | 16 of 19 |
| 10160 | Physician and practitioner services (fee schedule) | $48.28 | $69.52 | 16 of 19 |
| 10180 | Physician and practitioner services (fee schedule) | $91.02 | $148.10 | 17 of 19 |
| 11000 | Physician and practitioner services (fee schedule) | $20.73 | $24.52 | 13 of 19 |
| 11001 | Physician and practitioner services (fee schedule) | $10.52 | $12.36 | 14 of 19 |
| 11004 | Physician and practitioner services (fee schedule) | $436.33 | $437.21 | 11 of 19 |
| 11005 | Physician and practitioner services (fee schedule) | $593.90 | $573.02 | 9 of 19 |
| 11006 | Physician and practitioner services (fee schedule) | $549.43 | $542.16 | 8 of 19 |
| 11008 | Physician and practitioner services (fee schedule) | $212.89 | $206.56 | 7 of 19 |
| 11010 | Physician and practitioner services (fee schedule) | $140.68 | $225.24 | 18 of 19 |
| 11011 | Physician and practitioner services (fee schedule) | $151.06 | $229.46 | 17 of 19 |
| 11012 | Physician and practitioner services (fee schedule) | $211.79 | $326.26 | 16 of 19 |
| 11042 | Physician and practitioner services (fee schedule) | $30.46 | $50.80 | 18 of 19 |
| 11043 | Physician and practitioner services (fee schedule) | $78.04 | $134.21 | 17 of 19 |
| 11044 | Physician and practitioner services (fee schedule) | $116.20 | $182.12 | 17 of 19 |
| 11055 | Physician and practitioner services (fee schedule) | $9.82 | $14.80 | 18 of 19 |
| 11056 | Physician and practitioner services (fee schedule) | $16.45 | $20.38 | 14 of 19 |
| 11057 | Physician and practitioner services (fee schedule) | $21.43 | $26.13 | 14 of 19 |
| 11102 | Physician and practitioner services (fee schedule) | $25.52 | $32.23 | 15 of 19 |
| 11103 | Physician and practitioner services (fee schedule) | $15.31 | $18.65 | 14 of 19 |
| 11104 | Physician and practitioner services (fee schedule) | $31.09 | $40.43 | 16 of 19 |
| 11105 | Physician and practitioner services (fee schedule) | $12.98 | $22.05 | 17 of 19 |
| 11106 | Physician and practitioner services (fee schedule) | $38.78 | $49.21 | 15 of 19 |
Managed care in Ohio
21 plans on record, 34 state-directed payment records, 1,739 published capitation cells.
Who sets the rate, line by line →Recent rate changes and notices
Frequently asked questions
Where does Ohio publish its Medicaid fee schedules?
Ohio publishes rates across 134 official documents (fee schedules, rate notices and bulletins). Every rate on this page links to its source document.
How many Medicaid rates does Ohio publish?
43,217 rates are current across 119 services and 15 programs, with 263,852 versions on record since 1985-01-01.
Do Ohio Medicaid managed-care plans pay the fee schedule?
For 6 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 Ohio rate cardYour codes, what Ohio pays, what plans must pay, and every change in 2026.