STATE SPOTLIGHT · HAWAII
Hawaii Medicaid Rates: What's Published and How to Track Changes
Hawaii's Med-QUEST Division publishes some of the most complete free-tier rate data MedicaidBench tracks, spanning behavioral health, ABA, and primary care.
Analysis, guides, and updates for health plans, consultants, and providers navigating Medicaid fee schedules across all 50 states.
Behavioral health reimbursement — psychotherapy, psychiatric evaluation, ABA — varies significantly by state. Here's what the variation actually looks like using real published rates.
Hawaii's Med-QUEST Division publishes some of the most complete free-tier rate data MedicaidBench tracks, spanning behavioral health, ABA, and primary care.
HCBS spans four CMS-mandated categories — homemaker, home health aide, personal care, and habilitation. Here's what each covers and how states approach rate-setting differently for them.
Kentucky's Cabinet for Health and Family Services publishes Medicaid fee schedules covering behavioral health, ABA, and primary care codes. Here's what's currently published.
Louisiana's Healthy Louisiana program publishes fee schedules through LDH. Here's what current behavioral health and primary care rates look like.
Public Medicaid rate data can feed directly into an actuarial pipeline instead of being re-entered by hand every rate cycle. Here's a practical pattern for wiring it in.
A primer on the core CPT codes used for Applied Behavior Analysis (ABA) billing under Medicaid, and how reimbursement structures vary by state.
Mississippi publishes fee schedules with both a bulk spreadsheet and an interactive lookup tool. Here's what's currently published for behavioral health codes.
Fee schedules look different in every state, but the underlying fields — codes, modifiers, population, provider type, effective date — follow patterns once you know what to look for.
Michigan's Medicaid rates live in the CHAMPS Code and Rate Reference Tool rather than a static published fee schedule. Here's what that means and what's currently published.
How to build a systematic rate-monitoring workflow that catches Medicaid fee schedule changes before they affect your billing or capitation models.
Pennsylvania's public fee schedule search tool covers outpatient rates, with full bulk downloads reserved for enrolled providers. Here's what's currently published.
CMS requires states to report how Medicaid primary care rates compare to Medicare for certain E/M codes. Here's what that comparison measures, and why it matters beyond compliance reporting.
Our methodology for ingesting, normalizing, and verifying Medicaid FFS rate data from state fee schedules, CMS, and the DEA — and what "Verified" means on a rate record.
Illinois publishes fee schedules across 40+ provider categories through HFS. Here's what current behavioral health and primary care rates look like.
California's Medi-Cal rates are published through DHCS's Rates Explorer portal. Here's what current behavioral health and primary care rates look like, and why the source is more fragmented than most states.
How the Ohio Department of Medicaid publishes its fee schedule, what current behavioral health and primary care rates look like, and where to check for changes.
State Medicaid rate-setting isn't one process — it's dozens of different processes, each with its own cadence, triggers, and publication habits. Here's what's actually happening behind a fee schedule change.
State FFS rates are a foundational input for managed care capitation. Here's how to use them responsibly — and where the FFS-to-capitation translation breaks down.
New York publishes fee schedules through eMedNY's per-specialty provider manuals. Here's what current behavioral health and primary care rates look like, and how the format works.
The Medicaid-to-Medicare payment ratio is one of the most widely cited access metrics in Medicaid policy. Here's what it actually measures, and its limits.
Nebraska has some of the most complete free-tier data MedicaidBench tracks across behavioral health and primary care codes, with rates well above several larger states.
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