Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for H0004. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
- Full-schedule CSV export and state network lists
- Email alerts when a state changes its rates
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Publishing states
27
Median % of Medicare
--
Rate range
$10.00 - $162.68
H0004 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $45.52 | -- | -- | 2026 |
| California | $28.38 | -- | -- | 2026 |
| District of Columbia | $15.60 | -- | Varies | 2008 |
| Delaware | $22.10 | -- | -- | 2026 |
| Iowa | $18.32 | -- | -- | 2024 |
| Illinois | $26.62 | -- | -- | 2026 |
| Indiana | $18.56* | -- | Required | 2026 |
| Kentucky | $162.68 | -- | -- | 2026 |
| Louisiana | $10.00* | -- | -- | 2026 |
| Massachusetts | $33.10 | -- | -- | 2026 |
| Maryland | $31.06* | -- | -- | 2026 |
| Maine | $40.51* | -- | -- | 2026 |
| Michigan | $21.63 | -- | -- | 2026 |
| Missouri | $34.46 | -- | Not required | 2022 |
| North Carolina | $19.81 | -- | -- | 2012 |
| North Dakota | $28.65 | -- | Not required | 2026 |
| New Hampshire | $66.24 | -- | Not required | 2026 |
| Nevada | $31.79 | -- | -- | 2024 |
| Ohio | $11.25 | -- | -- | 2026 |
| South Dakota | $31.87 | -- | -- | 2026 |
| Texas | $23.51* | -- | -- | 2026 |
| Utah | $14.16* | -- | Not required | 2021 |
| Virginia | $25.56 | -- | -- | 2025 |
| Vermont | $30.62 | -- | -- | 2026 |
| Washington | $31.07 | -- | -- | 2026 |
| Wisconsin | $15.95 | -- | -- | 2025 |
| Wyoming | $26.76* | -- | -- | 2026 |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * are representative published variants or methodology-derived rates. "--" in the prior-auth column means the state publishes no PA flag.
Related behavioral health codes
- 90785 - Psychotherapy interactive complexity (add-on)
- 90791 - Psychiatric diagnostic evaluation, no medical services
- 90792 - Psychiatric diagnostic evaluation with medical services
- 90832 - Psychotherapy, 30 minutes
- 90833 - Psychotherapy, 30 minutes, added to an E&M visit
- 90834 - Psychotherapy, 45 minutes
- 90836 - Psychotherapy, 45 minutes, added to an E&M visit
- 90837 - Psychotherapy, 60 minutes
All 26 codes from H0001 to H0050 or every behavioral health code by number.
Frequently asked questions
How much does Medicaid pay for H0004?
27 state Medicaid programs publish a fee-for-service rate for H0004 (behavioral health counseling and therapy, per 15 minutes), ranging from $10.00 in Louisiana to $162.68 in Kentucky. The full table on this page lists every publishing state's current rate.
Which state pays the most for H0004?
Kentucky publishes the highest Medicaid rate for H0004 at $162.68. Louisiana publishes the lowest at $10.00.
Does H0004 require prior authorization under Medicaid?
1 of the 27 publishing states flag H0004 as requiring prior authorization (always or conditionally) on their fee schedules. States without a flag publish no PA indicator for this code - that means "not published", not "no PA required".