Skip to content
Billing code 876 · Hospital inpatient

876 Medicaid reimbursement rate by state (2026)

Inpatient DRG pricing input (outlier, cost ratio, stay). Medicaid pays a median of $1.43 for 876 across 12 states, from $0.2094 in Illinois to $2,224.15 in New Hampshire.

Data as of Oct 5, 202612 statesEvery rate links to its official source

States publishing
12
National median
$1.43units vary by state
Lowest
$0.2094Illinois
Highest
$2,224.15New Hampshire
Answer

What does Medicaid pay for 876?

12 state Medicaid programs publish a fee-for-service rate for 876. The national median is $1.43 (units differ between states). New Hampshire pays the most, $2,224.15, and Illinois the least, $0.2094, a 10621.5x spread.

State ranking

876 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 12 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1New Hampshire Source · since 2025-10-01$2,224.15——Plans must pay at least this—
2Kansas Source · since 2023-01-01$78.00——Plans must pay at least this—
3West Virginia Source · since 2025-10-01$5.95——Plans negotiate; applies out of network—
6Vermont Source · since 2025-10-01$1.66——Not classified—
7Iowa Source · since 2024-10-01$1.20——Plans must pay at least this—
8New York Source · since 2026-01-01$0.6968relative weight—Plans negotiate; applies out of network—
11District of Columbia Source · since 2024-10-01$0.2604——Plans must pay at least this—
12Illinois Source · since 2023-08-01$0.2094——Plans negotiate; applies out of network—
See all 12 states for 876 — start free

4 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

  • Source for every rate
  • Full rate history
  • CSV and API export

Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track 876 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
FAQ

Frequently asked questions

What does Medicaid pay for 876?

It depends on the state. Of the 12 states with a published fee-for-service rate, the median is $1.43. New Hampshire pays the most ($2,224.15) and Illinois the least ($0.2094).

Which state pays the highest Medicaid rate for 876?

New Hampshire, at $2,224.15, effective 2025-10-01.

Do managed-care plans pay the same rate for 876?

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.