422 Medicaid reimbursement rate by state (2026)
Inpatient DRG pricing input (outlier, cost ratio, stay). Medicaid pays a median of $1.51 for 422 across 13 states, from $0.161 in Virginia to $2,556.19 in New Hampshire.
- States publishing
- 13
- National median
- $1.51units vary by state
- Lowest
- $0.161Virginia
- Highest
- $2,556.19New Hampshire
What does Medicaid pay for 422?
13 state Medicaid programs publish a fee-for-service rate for 422. The national median is $1.51 (units differ between states). New Hampshire pays the most, $2,556.19, and Virginia the least, $0.161 per EAPG Weight Effective 7/1/2016, a 15877.0x spread.
422 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.
Frequently asked questions
What does Medicaid pay for 422?
It depends on the state. Of the 13 states with a published fee-for-service rate, the median is $1.51. New Hampshire pays the most ($2,556.19) and Virginia the least ($0.161 per EAPG Weight Effective 7/1/2016).
Which state pays the highest Medicaid rate for 422?
New Hampshire, at $2,556.19, effective 2025-10-01.
Do managed-care plans pay the same rate for 422?
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.