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040 Medicaid reimbursement rate by state (2026)

Inpatient DRG pricing input (outlier, cost ratio, stay). Medicaid pays a median of $3.73 for 040 across 10 states, from $1.00 in Hawaii to $2,252.88 in New Hampshire.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
10
National median
$3.73units vary by state
Lowest
$1.00Hawaii
Highest
$2,252.88New Hampshire

What does Medicaid pay for 040?

10 state Medicaid programs publish a fee-for-service rate for 040. The national median is $3.73 (units differ between states). New Hampshire pays the most, $2,252.88, and Hawaii the least, $1.00 per policy_adjuster_adult, a 2252.9x spread.

040 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 10 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1New Hampshire Source · since 2025-10-01$2,252.88——Plans must pay at least this—
2Kansas Source · since 2023-01-01$78.00——Plans must pay at least this—
3New York Source · since 2018-07-01$6.00days (average length of stay)—Suggested schedule for plans—
5Oregon Source · since 2025-10-01$3.86Weights - 10% Cap Applied—Not classified—
6Vermont Source · since 2025-10-01$3.60——Not classified—
9Iowa Source · since 2024-10-01$2.62——Plans must pay at least this—
10Hawaii Source · since 2024-01-01$1.00policy_adjuster_adult—State sets the plan rate—
See all 10 states for 040 — start free

3 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track 040 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.

Frequently asked questions

What does Medicaid pay for 040?

It depends on the state. Of the 10 states with a published fee-for-service rate, the median is $3.73. New Hampshire pays the most ($2,252.88) and Hawaii the least ($1.00 per policy_adjuster_adult).

Which state pays the highest Medicaid rate for 040?

New Hampshire, at $2,252.88, effective 2025-10-01.

Do managed-care plans pay the same rate for 040?

Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The workspace shows the rule for each state, cited to the contract or statute.