Skip to content

128 Medicaid reimbursement rate by state (2026)

EAPG relative weight (outpatient hospital or surgery center). Medicaid pays a median of $6.67 for 128 across 5 states, from $5.32 in Illinois to $14.41 in Wisconsin.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
5
National median
$6.67units vary by state
Lowest
$5.32Illinois
Highest
$14.41Wisconsin

What does Medicaid pay for 128?

5 state Medicaid programs publish a fee-for-service rate for 128. The national median is $6.67 (units differ between states). Wisconsin pays the most, $14.41, and Illinois the least, $5.32, a 2.7x spread.

128 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 5 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Wisconsin Source · since 2026-01-01$14.41——Plans negotiate; applies out of network—
2New York Source · since 2026-01-01$13.76relative weight—Plans negotiate; applies out of network—
3District of Columbia Source · since 2024-10-01$6.67——Plans must pay at least this—
See all 5 states for 128 — start free

2 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.

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

Frequently asked questions

What does Medicaid pay for 128?

It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $6.67. Wisconsin pays the most ($14.41) and Illinois the least ($5.32).

Which state pays the highest Medicaid rate for 128?

Wisconsin, at $14.41, effective 2026-01-01.

Do managed-care plans pay the same rate for 128?

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.