D0371 Medicaid reimbursement rates by state
Outpatient hospital services (fee schedule). 5 state Medicaid programs publish a fee-for-service rate for D0371. Rates run from $0.9726 in South Dakota to $230.00 in New Mexico, with a median of $0.9726.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 5
- Median rate
- $0.9726units vary by state
- Highest
- $230.00New Mexico
- Medicare (non-facility)
- —not on the physician fee schedule
D0371 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 |
|---|---|---|---|---|---|---|
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $230.00⚠ over 3× mediansince 2015-12-01 | — | — | Plans must pay at least this | — | OPPS Codes (NM Medicaid Hospital Outpati |
| WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health) | $78.27⚠ over 3× mediansince 2026-01-01 | — | — | Not classified | — | Wyoming Medicaid APC-Based Fee Schedule |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $0.9726since 2026-01-01 | — | — | Not classified | — | CMAP Addendum B - OPPS Payment Type by P |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $0.9726since 2026-01-01 | — | — | Plans must pay at least this | — | Iowa Medicaid Addendum B (CY 26-Janaury) |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $0.9726since 2026-02-27 | — | — | Not classified | — | Outpatient Hospital Prospective Payment |
Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 D0371?
It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $0.9726. New Mexico pays the most ($230.00) and South Dakota the least ($0.9726).
Which state pays the highest Medicaid rate for D0371?
New Mexico, at $230.00, effective 2015-12-01.
Do managed-care plans pay the same rate for D0371?
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.