526 Medicaid reimbursement rate by state (2026)
EAPG relative weight (outpatient hospital or surgery center). Medicaid pays a median of $0.4308 for 526 across 5 states, from $0.3449 in Illinois to $0.9799 in Wisconsin.
- States publishing
- 5
- National median
- $0.4308units vary by state
- Lowest
- $0.3449Illinois
- Highest
- $0.9799Wisconsin
What does Medicaid pay for 526?
5 state Medicaid programs publish a fee-for-service rate for 526. The national median is $0.4308 (units differ between states). Wisconsin pays the most, $0.9799, and Illinois the least, $0.3449, a 2.8x spread.
526 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.
Frequently asked questions
What does Medicaid pay for 526?
It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $0.4308. Wisconsin pays the most ($0.9799) and Illinois the least ($0.3449).
Which state pays the highest Medicaid rate for 526?
Wisconsin, at $0.9799, effective 2026-01-01.
Do managed-care plans pay the same rate for 526?
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.