317 Medicaid reimbursement rate by state (2026)
Inpatient DRG pricing input (outlier, cost ratio, stay). Medicaid pays a median of $3.78 for 317 across 15 states, from $0.2347 in Illinois to $5,507.79 in New Hampshire.
- States publishing
- 15
- National median
- $3.78units vary by state
- Lowest
- $0.2347Illinois
- Highest
- $5,507.79New Hampshire
What does Medicaid pay for 317?
15 state Medicaid programs publish a fee-for-service rate for 317. The national median is $3.78 (units differ between states). New Hampshire pays the most, $5,507.79, and Illinois the least, $0.2347, a 23467.4x spread.
317 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 15 states with every variant, modifier and effective date.
How to read this table
- Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for 317, so the order is by published amount and is not a like-for-like rank.
- Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 7 of the 15 states list more than one rate for 317, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
- Unit. Of the 15 states, 2 publish 317 per relative weight, 1 per weights - 10% cap applied, 1 per weight and 1 in other units, and 10 schedules print no unit at all (a flat amount per service).
- Per hour. 317 is not billed in time units in these states, so no hourly figure is shown.
- Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
- % of Medicare. No Medicare physician fee schedule amount is on file for 317, so there is no percentage.
- Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Why 317 rates differ between states
Published rates for 317 run from $0.2347 in Illinois to $5,507.79 in New Hampshire, a 23467.4x gap in the same unit. Half the states pay more than the median of $3.78 and half pay less. The usual reasons for a spread like this in hospital inpatient rates:
- Some states still pay certain hospitals or stays per day instead of per discharge.
- States use different inpatient grouper systems, so a diagnosis-related group weight in one state is not comparable with a weight from another grouper.
- Base rates are often hospital-specific, adjusted for wages, teaching and other factors, so the same weight produces a different payment at each hospital.
Timing matters too. 4 states set the current rate for 317 in 2026 or later, while 1 state still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.
What managed-care plans pay for 317
No managed-care plan publishes what it pays for 317. What is public is the rule each state's plan contracts set, and that rule decides how much the published rate matters when you contract with a plan.
In 7 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 6 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 2 states is not classified yet.
- Plans must pay at least the published rate (6 states). The published rate is your floor. Negotiate up from it, and if a plan pays less, the contract provision is the basis for a payment dispute.
- Plans negotiate; the published rate applies out of network (6 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.
- The state sets the plan rate (1 state). There is little to negotiate on price. Contracting is about network participation, authorization and billing terms.
Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example New Hampshire managed care.
Units and billing for 317
317 is a inpatient DRG in the hospital inpatient line, billed mostly by hospitals. Inpatient stays are paid per discharge: a diagnosis-related group weight multiplied by a hospital base rate, with outlier payments for unusually costly stays. A value on this page can therefore be a weight or a pricing input, not dollars.
A value here may be a relative weight, an average length of stay, an outlier threshold or another pricing input. The payment is the weight multiplied by the hospital's base rate.
Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.
Frequently asked questions
What does Medicaid pay for 317?
It depends on the state. Of the 15 states with a published fee-for-service rate, the median is $3.78. New Hampshire pays the most ($5,507.79) and Illinois the least ($0.2347).
Which state pays the highest Medicaid rate for 317?
New Hampshire, at $5,507.79, effective 2025-10-01.
Which state pays the lowest Medicaid rate for 317?
Illinois, at $0.2347, effective 2023-08-01.
What unit is 317 billed in?
Of the 15 states, 2 publish 317 per relative weight, 1 per weights - 10% cap applied, 1 per weight and 1 in other units, and 10 schedules print no unit at all (a flat amount per service).
Do managed-care plans pay the same rate for 317?
Not necessarily. In 7 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 6 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 2 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.