469 Medicaid reimbursement rate by state (2026)
Inpatient DRG pricing input (outlier, cost ratio, stay). Medicaid pays a median of $3.72 for 469 across 11 states, from $1.00 in Hawaii to $3,861.32 in New Hampshire.
- States publishing
- 11
- National median
- $3.72units vary by state
- Lowest
- $1.00Hawaii
- Highest
- $3,861.32New Hampshire
What does Medicaid pay for 469?
11 state Medicaid programs publish a fee-for-service rate for 469. The national median is $3.72 (units differ between states). New Hampshire pays the most, $3,861.32, and Hawaii the least, $1.00 per policy_adjuster_adult, a 3861.3x spread.
469 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 11 states with every variant, modifier and effective date.
Frequently asked questions
What does Medicaid pay for 469?
It depends on the state. Of the 11 states with a published fee-for-service rate, the median is $3.72. New Hampshire pays the most ($3,861.32) and Hawaii the least ($1.00 per policy_adjuster_adult).
Which state pays the highest Medicaid rate for 469?
New Hampshire, at $3,861.32, effective 2025-10-01.
Do managed-care plans pay the same rate for 469?
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.