565 Medicaid reimbursement rate by state (2026)
Inpatient DRG pricing input (outlier, cost ratio, stay). Medicaid pays a median of $1.00 for 565 across 11 states, from $0.2418 in Virginia to $1,240.43 in New Hampshire.
- States publishing
- 11
- National median
- $1.00units vary by state
- Lowest
- $0.2418Virginia
- Highest
- $1,240.43New Hampshire
What does Medicaid pay for 565?
11 state Medicaid programs publish a fee-for-service rate for 565. The national median is $1.00 (units differ between states). New Hampshire pays the most, $1,240.43, and Virginia the least, $0.2418 per EAPG Weight Effective 7/1/2016, a 5130.0x spread.
565 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 565?
It depends on the state. Of the 11 states with a published fee-for-service rate, the median is $1.00. New Hampshire pays the most ($1,240.43) and Virginia the least ($0.2418 per EAPG Weight Effective 7/1/2016).
Which state pays the highest Medicaid rate for 565?
New Hampshire, at $1,240.43, effective 2025-10-01.
Do managed-care plans pay the same rate for 565?
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.