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Billing code 0558T · Hospital outpatient

0558T Medicaid reimbursement rate by state (2026)

Outpatient hospital services (fee schedule). Medicaid pays a median of $7.56 for 0558T across 5 states, from $0.9726 in Iowa to $62.30 in New Mexico.

Data as of Oct 5, 20265 statesEvery rate links to its official source

States publishing
5
National median
$7.56units vary by state
Lowest
$0.9726Iowa
Highest
$62.30New Mexico
Answer

What does Medicaid pay for 0558T?

5 state Medicaid programs publish a fee-for-service rate for 0558T. The national median is $7.56 (units differ between states). New Mexico pays the most, $62.30, and Iowa the least, $0.9726, a 64.1x spread.

State ranking

0558T rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 5 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1New Mexico Source · since 2019-07-01$62.30——Plans must pay at least this—
2Utah Source · since 2023-07-01$25.09——Plans negotiate; applies out of network—
3Kansas Source · since 2019-07-01$7.56——Not classified—
See all 5 states for 0558T — start free

2 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.

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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 0558T in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
FAQ

Frequently asked questions

What does Medicaid pay for 0558T?

It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $7.56. New Mexico pays the most ($62.30) and Iowa the least ($0.9726).

Which state pays the highest Medicaid rate for 0558T?

New Mexico, at $62.30, effective 2019-07-01.

Do managed-care plans pay the same rate for 0558T?

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.