042 Medicaid reimbursement rate by state (2026)
Inpatient DRG pricing input (outlier, cost ratio, stay). Medicaid pays a median of $2.09 for 042 across 10 states, from $0.7553 in Iowa to $3,155.65 in New Hampshire.
- States publishing
- 10
- National median
- $2.09units vary by state
- Lowest
- $0.7553Iowa
- Highest
- $3,155.65New Hampshire
What does Medicaid pay for 042?
10 state Medicaid programs publish a fee-for-service rate for 042. The national median is $2.09 (units differ between states). New Hampshire pays the most, $3,155.65, and Iowa the least, $0.7553, a 4178.0x spread.
042 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.
Frequently asked questions
What does Medicaid pay for 042?
It depends on the state. Of the 10 states with a published fee-for-service rate, the median is $2.09. New Hampshire pays the most ($3,155.65) and Iowa the least ($0.7553).
Which state pays the highest Medicaid rate for 042?
New Hampshire, at $3,155.65, effective 2025-10-01.
Do managed-care plans pay the same rate for 042?
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.