498 Medicaid reimbursement rate by state (2026)
Inpatient DRG pricing input (outlier, cost ratio, stay). Medicaid pays a median of $3.22 for 498 across 8 states, from $1.26 in New Mexico to $2,880.33 in New Hampshire.
- States publishing
- 8
- National median
- $3.22units vary by state
- Lowest
- $1.26New Mexico
- Highest
- $2,880.33New Hampshire
What does Medicaid pay for 498?
8 state Medicaid programs publish a fee-for-service rate for 498. The national median is $3.22 (units differ between states). New Hampshire pays the most, $2,880.33, and New Mexico the least, $1.26, a 2282.7x spread.
498 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 8 states with every variant, modifier and effective date.
Frequently asked questions
What does Medicaid pay for 498?
It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $3.22. New Hampshire pays the most ($2,880.33) and New Mexico the least ($1.26).
Which state pays the highest Medicaid rate for 498?
New Hampshire, at $2,880.33, effective 2025-10-01.
Do managed-care plans pay the same rate for 498?
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.