426 Medicaid reimbursement rate by state (2026)
Inpatient DRG pricing input (outlier, cost ratio, stay). Medicaid pays a median of $7.84 for 426 across 12 states, from $0.043 in Virginia to $6,342.41 in New Hampshire.
- States publishing
- 12
- National median
- $7.84units vary by state
- Lowest
- $0.043Virginia
- Highest
- $6,342.41New Hampshire
What does Medicaid pay for 426?
12 state Medicaid programs publish a fee-for-service rate for 426. The national median is $7.84 (units differ between states). New Hampshire pays the most, $6,342.41, and Virginia the least, $0.043 per EAPG Weight Effective 7/1/2016, a 147497.9x spread.
426 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 12 states with every variant, modifier and effective date.
Frequently asked questions
What does Medicaid pay for 426?
It depends on the state. Of the 12 states with a published fee-for-service rate, the median is $7.84. New Hampshire pays the most ($6,342.41) and Virginia the least ($0.043 per EAPG Weight Effective 7/1/2016).
Which state pays the highest Medicaid rate for 426?
New Hampshire, at $6,342.41, effective 2025-10-01.
Do managed-care plans pay the same rate for 426?
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.