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Medicaid reimbursement intelligence

Every Medicaid rate and the rules behind it, state by state.

Fee-for-service rates, managed-care payment rules, directed payments and rate changes, normalized by code, program and provider level. Every number links to the official document it came from.

States live
17
Sourced rates
5,461,654
Billing codes
30,237
Rate card for one state's billing codes
Managed care

Most Medicaid dollars flow through plans. We show what binds them.

No managed-care plan publishes its provider fee schedule. What is public is what matters most in a negotiation: the rules plans must follow, the rates the state sets for them, and what the state adds on top. We capture all of it from plan contracts, statutes, notices and federal filings, and tag every rate with the rule that governs it.

See who sets the rate →
  1. Binding rule

    What plans must pay

    Contract and statute floors, required pass-throughs of state increases, and state-set rates plans must use. Tagged on every rate it governs.

  2. State-set

    Rates the state sets for plans

    Services where the state fixes the rate, such as long-term services and supports, behavioral health and IDD in many states.

  3. Directed payment

    What the state adds on top

    Approved directed payments: uniform increases, minimum fee schedules and the state's own estimate of what plans pay compared with Medicare or commercial.

  4. Capitation

    What the state pays plans

    Per-member-per-month rates by region and rate cell, where states publish them.

  5. Roster

    Which plans operate

    Plans, programs, parent companies and enrollment by state.

Primary sources only

State fee schedules, rate disclosures, provider bulletins, plan contracts and federal approvals. No estimates, no crowdsourcing.

Versioned by effective date

Every schedule kept, so you can see the rate on any date of service and every change since.

Like for like

Units, provider levels and add-ons matched before any state is ranked against another.

Pricing

Priced for the decisions it informs

A single rate negotiation or avoided cut pays for a year. Annual plans save two months.

Operator
For a provider organization in one state.
$249 / month
  • One state, every service line
  • Rate card for your billing codes
  • Managed-care rules and directed payments
  • Rate-change tracking (email alerts soon)
  • CSV and PDF export
  • Medicare comparison
  • 3 seats
Start 14-day trial
Enterprise
For investors, health plans, health systems and agencies.
From $1,500 / month
  • Everything in Professional
  • Unlimited seats
  • Bulk data delivery
  • Named analyst support
  • SSO and custom report packs (coming soon)
Start a trial
API
For billing, RCM, EVV and analytics platforms.
From $500 / month
  • Full REST API, every endpoint
  • Effective-dated rates and change events
  • Coverage and prior-auth rules
  • Production rate limits and SLA
Read the API reference

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Medicaid rates by state