Skip to content
Billing code 235 · Hospital inpatient

235 Medicaid reimbursement rate by state (2026)

Inpatient DRG pricing input (outlier, cost ratio, stay). Medicaid pays a median of $7.08 for 235 across 13 states, from $2.62 in Illinois to $3,081.72 in New Hampshire.

Data as of Oct 5, 202613 statesEvery rate links to its official source

States publishing
13
National median
$7.08units vary by state
Lowest
$2.62Illinois
Highest
$3,081.72New Hampshire
Answer

What does Medicaid pay for 235?

13 state Medicaid programs publish a fee-for-service rate for 235. The national median is $7.08 (units differ between states). New Hampshire pays the most, $3,081.72, and Illinois the least, $2.62, a 1175.2x spread.

State ranking

235 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 13 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1New Hampshire Source · since 2025-10-01$3,081.72——Plans must pay at least this—
2Kansas Source · since 2023-01-01$78.00——Plans must pay at least this—
3Wisconsin Source · since 2026-01-01$12.02——Plans negotiate; applies out of network—
6North Carolina Source · since 2026-10-01$9.00——Plans must pay at least this—
7West Virginia Source · since 2025-10-01$7.08——Plans negotiate; applies out of network—
8Oregon Source · since 2025-10-01$5.87Weights - 10% Cap Applied—Not classified—
12Vermont Source · since 2025-10-01$3.69——Not classified—
13Illinois Source$2.62——Plans negotiate; applies out of network—
See all 13 states for 235 — start free

5 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.

  • Source for every rate
  • Full rate history
  • CSV and API export

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 235 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 235?

It depends on the state. Of the 13 states with a published fee-for-service rate, the median is $7.08. New Hampshire pays the most ($3,081.72) and Illinois the least ($2.62).

Which state pays the highest Medicaid rate for 235?

New Hampshire, at $3,081.72, effective 2025-10-01.

Do managed-care plans pay the same rate for 235?

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.