Inpatient hospital (percent of charges or cost): Medicaid rates by state

A billing code alone doesn't make a fair comparison: states bill inpatient hospital (percent of charges or cost) under different codes, units and provider types. This benchmark lines up one comparable rate per state.

• Provider level. States are compared at the same provider level wherever the schedule distinguishes one. Rates for other levels on file (any qualified provider) are kept separate, never mixed into this ranking.
• Unit. Of the 2 states, 1 publish their headline rate per inpatient interim rates, and 1 schedule prints no unit at all (a flat amount per service). The ranking uses the rate as published, so read the unit before comparing two states.
• Variants. 2 of the 2 states publish more than one rate for this service (by modifier, program, setting or provider type); the headline rate is the one that matches the comparison, and the workspace lists every variant.
• Depth. 75 rates for this service are on file across all states, versions and provider levels; this page shows one headline rate per state.

The highest-paying state, South Dakota, pays $95.00; the lowest, Oregon, pays $0.72, a 131.9x gap. 2 of the 2 states pay above the median of —. Common reasons rates for hospital inpatient services spread this way:

• States use different inpatient grouper systems, so a diagnosis-related group weight in one state is not comparable with a weight from another grouper.
• Base rates are often hospital-specific, adjusted for wages, teaching and other factors, so the same weight produces a different payment at each hospital.
• Some states still pay certain hospitals or stays per day instead of per discharge.

Billing notes

A value here may be a relative weight, an average length of stay, an outlier threshold or another pricing input. The payment is the weight multiplied by the hospital's base rate.