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Data & methodology

How every number is sourced, normalized and compared.

Sources

Official publications only: state Medicaid fee schedules and rate disclosures, provider bulletins and public notices, managed-care plan contracts and rate guides, state plan amendments and waivers, CMS-approved state-directed payment filings, and CMS Medicare payment files. Every value carries its source document, the location inside it, and the date we retrieved it. Nothing is estimated, imputed or crowdsourced.

Versions and history

Each published schedule is kept with its effective dates, so you can see the rate on any date of service and every change since. A rate that was replaced is marked superseded, never deleted. History comes from the agencies' own archives and from archived copies of their pages; gaps are documented, never filled in.

Normalization

Codes, modifiers, programs, provider levels and units are mapped to a shared taxonomy so like can be compared with like. Units come from the source, or from the code's own definition when the source prints none. Per-hour equivalents are computed only for time-based units. Official code descriptors are not reproduced.

Comparisons

A state's headline rate for a code matches the provider level, setting and unit used across states, excluding add-ons. States are ranked only against states with the same unit. “% of Medicare” is shown only when the Medicaid rate uses the code's own billing unit.

Managed care

No managed-care plan publishes its provider fee schedule. For each state and service line we record what plans must do, taken from plan contracts, statutes and notices: pay at least the published rate, pay a state-set rate, negotiate freely, or pass the service to the state. Each rule is cited. Directed payments and the state's own payment-level estimates are shown separately and never mixed into fee-for-service benchmarks.

Medicare

Medicare physician fee schedule amounts are computed from the CMS relative value file and locality cost indices with the formula CMS publishes ([work RVU × work GPCI + PE RVU × PE GPCI + MP RVU × MP GPCI] × conversion factor), non-facility and facility. States with several Medicare localities show a range.

Quality checks

A state is published only after its data passes a release gate: every row mapped, units checked, a sample re-read against the source documents, overlapping and conflicting versions resolved. Corrections are applied as new versions with the reason recorded.

Coverage by state

Live from the database. 20 states, 6,153,055 sourced rates. More states are added as they pass the release gate.

StateRatesCodesLast retrieved
Arizona612,40016,4532026-10-02
California936,34018,1222026-10-02
Colorado248,65515,3482026-10-05
Florida330,07413,4332026-10-02
Georgia52,54112,2072026-10-02
Illinois293,58515,1812026-10-02
Indiana76,93315,1052026-10-02
Massachusetts55,05711,7022026-10-02
Michigan198,07813,3342026-10-02
Minnesota129,72114,9212026-10-05
Nebraska280,47414,5062026-10-02
New Jersey247,20916,0192026-10-02
New York635,26612,2512026-10-02
North Carolina573,65112,7942026-10-02
Ohio263,85215,8772026-10-02
Pennsylvania127,8749,8272026-10-02
Tennessee2,9504982026-10-02
Texas534,27815,5922026-10-02
Virginia313,02544,3532026-10-02
Washington241,09214,6332026-10-02

Use of this data

Rates are reported as published. Confirm with the payer before billing. See the Terms of Service.

Medicaid rates by state
ArizonaCaliforniaColoradoFloridaGeorgiaIllinoisIndianaMassachusettsMichiganMinnesotaNebraskaNew JerseyNew YorkNorth CarolinaOhioPennsylvaniaTennesseeTexasVirginiaWashington