341 Medicaid reimbursement rate by state (2026)
Inpatient DRG pricing input (outlier, cost ratio, stay). Medicaid pays a median of $1.05 for 341 across 6 states, from $0.1274 in Illinois to $4.00 in New York.
- States publishing
- 6
- National median
- $1.05units vary by state
- Lowest
- $0.1274Illinois
- Highest
- $4.00New York
What does Medicaid pay for 341?
6 state Medicaid programs publish a fee-for-service rate for 341. The national median is $1.05 (units differ between states). New York pays the most, $4.00 per days (average length of stay), and Illinois the least, $0.1274, a 31.4x spread.
341 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 6 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 341, 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. 6 of the 6 states list more than one rate for 341, 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 6 states, 1 publish 341 per days (average length of stay), 1 per weight, 1 per policy_adjuster_adult and 1 in other units, and 2 schedules print no unit at all (a flat amount per service).
- Per hour. 341 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 341, 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 341 rates differ between states
Published rates for 341 run from $0.1274 in Illinois to $4.00 in New York. The two publish it in different units (days (average length of stay) versus no unit printed), so part of that gap is the unit rather than the price. Half the states pay more than the median of $1.05 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. None of the states changed its rate for 341 in 2026, while 2 states 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 341
Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For 341, the public signal is the rule each state sets for its plans, recorded on each rate above.
In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 4 states, plans negotiate and the published rate is a benchmark or out-of-network default.
- Plans negotiate; the published rate applies out of network (3 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.
- Suggested schedule for plans (1 state). Use the schedule as a public benchmark in negotiations; the actual rate is whatever you and the plan agree.
- Plans must pay at least the published rate (1 state). 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.
- 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 York managed care.
Units and billing for 341
341 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 341?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $1.05. New York pays the most ($4.00 per days (average length of stay)) and Illinois the least ($0.1274).
Which state pays the highest Medicaid rate for 341?
New York, at $4.00 per days (average length of stay), effective 2018-07-01.
Which state pays the lowest Medicaid rate for 341?
Illinois, at $0.1274. It publishes the code in a different unit from New York, so compare per unit with care.
What unit is 341 billed in?
Of the 6 states, 1 publish 341 per days (average length of stay), 1 per weight, 1 per policy_adjuster_adult and 1 in other units, and 2 schedules print no unit at all (a flat amount per service).
Do managed-care plans pay the same rate for 341?
Not necessarily. In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 4 states, plans negotiate and the published rate is a benchmark or out-of-network default. Each rule is cited to the plan contract, statute or notice in the workspace.