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 — 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 |
|---|---|---|---|---|
| Detroit, MI | $223.48 | $0.00 – $619.17 | 1,161,325 | 42 |
| San Diego, CA | $165.41 | $0.00 – $743.36 | 1,182,202 | 159 |
| Rochester, NY | $416.23 | $0.00 – $526.19 | 1,188,020 | 14 |
| Cincinnati, OH | $46.17 | $0.00 – $1,269 | 1,228,372 | 204 |
| Philadelphia, PA | $98.17 | $0.00 – $404.95 | 1,251,914 | 215 |
| Yuma, AZ | $40.54 | $0.00 – $87.32 | 1,260,940 | 30 |
| Saint Paul, MN | $154.70 | $0.00 – $868.58 | 1,271,971 | 54 |
| Sacramento, CA | $101.96 | $0.00 – $432.48 | 1,337,952 | 139 |
| Doral, FL | $46.83 | $14.88 – $146.52 | 1,368,269 | 40 |
| Peekskill, NY | $322.20 | $316.11 – $329.13 | 1,420,925 | 2 |
| Hialeah, FL | $57.62 | $0.00 – $3,517 | 1,437,779 | 71 |
| Knoxville, TN | $11.55 | $0.00 – $245.24 | 1,534,932 | 46 |
| Gilbert, AZ | $34.25 | $0.17 – $1,759 | 1,555,740 | 32 |
| Brooklyn, NY | $100.85 | $0.00 – $446.40 | 1,582,479 | 95 |
| Milwaukee, WI | $88.79 | $0.00 – $428.54 | 1,899,271 | 86 |
| Las Vegas, NV | $146.39 | $0.00 – $1,225 | 1,913,716 | 216 |
| Los Angeles, CA | $149.10 | $0.00 – $573.73 | 1,948,149 | 348 |
| Chicago, IL | $72.76 | $0.00 – $277.22 | 1,956,668 | 134 |
| Murfreesboro, TN | $0.00 | $0.00 – $0.00 | 1,984,949 | 5 |
| Glendale, AZ | $20.27 | $0.00 – $970.14 | 2,139,673 | 60 |
| Tempe, AZ | $35.58 | $0.00 – $1,618 | 2,422,544 | 92 |
| Mesa, AZ | $32.09 | $0.00 – $3,067 | 2,470,619 | 181 |
| Oklahoma City, OK | $178.61 | $0.00 – $864.82 | 2,960,059 | 360 |
| Montgomery, AL | $50.35 | $0.00 – $466.67 | 3,554,330 | 24 |
| New York, NY | $322.62 | $0.00 – $744.00 | 3,682,218 | 65 |
| Miami, FL | $82.94 | $0.00 – $4,340 | 3,929,993 | 325 |
| Nashville, TN | $197.77 | $0.00 – $857.43 | 5,117,343 | 28 |
| Tucson, AZ | $33.22 | $0.00 – $1,173 | 5,915,648 | 255 |
| Phoenix, AZ | $37.73 | $0.00 – $6,668 | 14,607,817 | 601 |
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.