0510 Medicaid reimbursement rates by state
Outpatient hospital services (fee schedule). 5 state Medicaid programs publish a fee-for-service rate for 0510. Rates run from $0.5807 in Washington to $55.61 in Virginia, with a median of $2.88.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 5
- Median rate
- $2.88units vary by state
- Highest
- $55.61Virginia
- Medicare (non-facility)
- —not on the physician fee schedule
0510 rate in every state
One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $55.61since 2003-04-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file revenue.csv |
| WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health) | $35.00since 1994-07-01 | — | — | Not classified | — | Wyoming Medicaid Downloadable Fee Schedu |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $2.88since 2025-10-01 | — | — | Plans must pay at least this | — | DRG Base Rate Oct 2025 - web (OKLAHOMA H |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $2.76since 2026-01-01 | weight | — | Plans must pay at least this | — | Utah Medicaid MS-DRG Payment Calculation |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service hospital rates | $0.5807since 2022-07-01 | — | — | Plans must pay at least this | — | opps-weights-20220701.xlsx |
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 with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.
Frequently asked questions
What does Medicaid pay for 0510?
It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $2.88. Virginia pays the most ($55.61) and Washington the least ($0.5807).
Which state pays the highest Medicaid rate for 0510?
Virginia, at $55.61, effective 2003-04-01.
Do managed-care plans pay the same rate for 0510?
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 table shows the rule for each state, cited to the contract or statute.