772 Medicaid reimbursement rates by state
Outpatient hospital services (fee schedule). 6 state Medicaid programs publish a fee-for-service rate for 772. Rates run from $0.2356 in Illinois to $28.51 in Vermont, with a median of $1.51.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 6
- Median rate
- $1.51units vary by state
- Highest
- $28.51Vermont
- Medicare (non-facility)
- —not on the physician fee schedule
772 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 |
|---|---|---|---|---|---|---|
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $28.51since 2026-02-01 | — | — | Not classified | — | DVHA OPPS Fee Schedule workbook, Septemb |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service and managed care default rates) | $22.00since 2018-07-01 | days (average length of stay) | — | Suggested schedule for plans | — | NYS DOH Final APR-DRG Service Intensity |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $1.86since 2024-01-01 | weight | — | Plans negotiate; applies out of network | — | Georgia Inpatient DRG System - DRG Weigh |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service | $1.15since 2024-01-01 | policy_adjuster_adult | — | State sets the plan rate | — | Hawai`i January 2026 v1.0 DRG Calculator |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $0.2637since 2019-07-01 | EAPG WEIGHT | — | Plans negotiate; applies out of network | — | EAPG Weights Version 3.13 |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $0.2356since 2019-10-01 | — | — | Plans negotiate; applies out of network | — | Outpatient Calculator Effective July 1, |
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 772?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $1.51. Vermont pays the most ($28.51) and Illinois the least ($0.2356).
Which state pays the highest Medicaid rate for 772?
Vermont, at $28.51, effective 2026-02-01.
Do managed-care plans pay the same rate for 772?
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.