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Based on public Medicaid payment data.

Average Medicaid Case Management Services Payments

Typical Medicaid Case Management Services reimbursement across 4,179 cities

Avg. Medicaid Paid

$112.01

Price Range

$0.00 – $5,124

Total Claims

224.4M

Cities

4179

Typical Payment Range

Typical Medicaid Case Management Services payments fall between $29.56 and $179.61 per claim (median: $67.41). The top 10% of payments exceed $299.49.

Based on per-provider averages across all Medicaid claims in this category.

About This Procedure

Care coordination services that help patients navigate the healthcare system, connect with resources, and manage complex medical or social needs.

Why do these costs look low?

These figures represent Medicaid reimbursement rates β€” the amounts that state Medicaid programs actually paid providers. Medicaid typically reimburses significantly less than private insurance or out-of-pocket prices. If you have private insurance or are paying cash, expect higher costs. See the cost components below for per-code averages.

Costs by City

City Avg. Paid Min / Max Claims Providers
Ada, OK $57.49 $17.02 – $451.66 73,646 33
Elk Grove Village, IL $47.63 $47.63 – $47.63 73,899 1
Hollywood, FL $58.70 $1.47 – $77.24 74,141 15
Reidsville, NC $116.22 $9.25 – $131.82 74,270 4
Santa Fe, NM $295.27 $19.93 – $580.30 74,332 12
Benton Harbor, MI $337.01 $337.01 – $337.01 74,384 1
Roslyn Heights, NY $37.66 $37.66 – $37.66 74,458 1
Leonardtown, MD $138.35 $100.70 – $164.04 74,976 5
Pomona, CA $119.43 $4.08 – $320.69 75,201 18
Barrington, RI $153.18 $40.12 – $193.95 75,493 4
Belleville, IL $38.85 $26.97 – $59.02 75,632 4
Marina, CA $239.81 $107.08 – $409.76 75,870 7
Rocky Mount, NC $61.65 $55.21 – $69.03 76,047 2
Hazard, KY $284.15 $0.00 – $416.98 76,315 28
Sewell, NJ $754.75 $201.84 – $894.00 76,413 3
Southfield, MI $584.60 $1.89 – $662.10 76,489 9
Fresh Meadows, NY $44.68 $27.65 – $48.80 76,622 3
Arlington Heights, IL $86.31 $54.28 – $91.58 77,384 2
Fort Gratiot, MI $560.51 $0.00 – $560.75 77,439 2
Casper, WY $187.76 $0.00 – $341.67 77,505 69
Kingsford, MI $177.86 $177.86 – $177.86 77,624 1
Uniontown, PA $143.57 $85.02 – $268.93 77,859 6
Little Rock, AR $62.23 $0.00 – $176.52 77,970 28
Danville, VA $292.33 $24.04 – $326.25 78,243 7
Ville Platte, LA $177.11 $172.70 – $195.21 78,311 2
Monroe, LA $157.85 $17.12 – $199.18 78,554 9
Pueblo, CO $132.06 $0.00 – $252.54 78,806 20
Ellisville, MS $186.66 $122.63 – $204.70 78,910 2
Mooresville, NC $50.45 $0.00 – $80.90 79,184 3
Leesburg, FL $100.21 $25.98 – $3,879 79,187 12
Pembroke Pines, FL $67.05 $0.00 – $82.39 79,202 14
West St Paul, MN $74.71 $73.68 – $275.69 79,821 2
Gaffney, SC $47.62 $45.61 – $58.01 80,272 3
Rochester, MN $197.22 $11.74 – $1,278 80,275 28
Baldwin City, KS $37.15 $37.15 – $37.15 80,592 1
Merced, CA $230.92 $13.90 – $377.10 80,610 21
Doylestown, PA $74.64 $0.00 – $80.76 80,772 3
Abingdon, VA $224.51 $23.62 – $264.82 81,490 21
Idabel, OK $60.87 $22.45 – $144.31 81,517 8
Houlton, ME $51.15 $50.45 – $130.38 81,567 3
Santa Cruz, CA $218.33 $0.00 – $801.31 81,572 28
Edison, NJ $867.74 $0.00 – $891.99 81,656 3
Bartlesville, OK $52.58 $0.00 – $617.08 81,700 79
Thibodaux, LA $169.30 $0.00 – $190.72 81,747 7
Jamestown, NY $315.55 $315.55 – $315.55 81,857 1
Camarillo, CA $154.93 $95.70 – $724.61 81,955 7
Colo Spgs, CO $44.81 $44.81 – $44.81 82,177 1
Orchard Park, NY $150.50 $22.56 – $261.24 82,354 5
Pensacola, FL $27.39 $0.00 – $145.44 82,403 37
Duncan, OK $75.72 $8.17 – $144.74 82,655 13

Cost Components

National averages for each billing code in this procedure category. Sorted by claim volume.

Code Description Avg. Paid Claims Providers
T1016 Case management $53.04 98,273,616 8,345
T1017 Targeted case management $112.10 75,144,121 9,742
G9012 Other specified case mgmt $107.65 20,935,656 2,248
T2022 Case management, per month $203.72 18,391,337 2,261
G9005 Mccd, risk adj, maintenance $160.92 12,898,667 261
T2023 Targeted case mgmt per month $413.92 12,595,953 2,134
G9008 Mccd,phys coor-care ovrsght $74.59 4,952,338 1,128
G9002 Mccd,maintenance rate $93.74 4,503,842 1,749
G9010 Mccd, risk adj, level 4 $4.35 2,996,162 176
G9006 Mccd, home monitoring $83.36 2,206,712 1,176
G9004 Mccd, risk adj lo, initial $17.14 1,881,109 123
G9011 Mccd, risk adj, level 5 $1.80 1,085,895 76
G9007 Mccd, sch team conf $30.13 764,968 640
G0506 Comp asses care plan ccm svc $32.42 655,789 933
G9001 Mccd, initial rate $212.13 505,177 339
G9003 Mccd, risk adj hi, initial $316.88 201,792 84
G9009 Mccd, risk adj, level 3 $203.75 153,433 534

These averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.