225 Medicaid reimbursement rate by state (2026)
EAPG relative weight (outpatient hospital or surgery center). Medicaid pays a median of $5.66 for 225 across 6 states, from $2.00 in New York to $13.42 in Wisconsin.
- States publishing
- 6
- National median
- $5.66units vary by state
- Lowest
- $2.00New York
- Highest
- $13.42Wisconsin
What does Medicaid pay for 225?
6 state Medicaid programs publish a fee-for-service rate for 225. The national median is $5.66 (units differ between states). Wisconsin pays the most, $13.42, and New York the least, $2.00 per days (average length of stay), a 6.7x spread.
225 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 6 states with every variant, modifier and effective date.
Frequently asked questions
What does Medicaid pay for 225?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $5.66. Wisconsin pays the most ($13.42) and New York the least ($2.00 per days (average length of stay)).
Which state pays the highest Medicaid rate for 225?
Wisconsin, at $13.42, effective 2026-01-01.
Do managed-care plans pay the same rate for 225?
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.