869 Medicaid reimbursement rate by state (2026)
Inpatient DRG pricing input (outlier, cost ratio, stay). Medicaid pays a median of $0.6774 for 869 across 13 states, from $0.1832 in Illinois to $1,277.27 in New Hampshire.
- States publishing
- 13
- National median
- $0.6774units vary by state
- Lowest
- $0.1832Illinois
- Highest
- $1,277.27New Hampshire
What does Medicaid pay for 869?
13 state Medicaid programs publish a fee-for-service rate for 869. The national median is $0.6774 (units differ between states). New Hampshire pays the most, $1,277.27, and Illinois the least, $0.1832, a 6972.0x spread.
869 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 869?
It depends on the state. Of the 13 states with a published fee-for-service rate, the median is $0.6774. New Hampshire pays the most ($1,277.27) and Illinois the least ($0.1832).
Which state pays the highest Medicaid rate for 869?
New Hampshire, at $1,277.27, effective 2025-10-01.
Do managed-care plans pay the same rate for 869?
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.