G0316 Medicaid reimbursement rate by state (2026)
Prolonged hospital inpatient or observation care evaluation.... Medicaid pays a median of $25.88 per 15 min for G0316 across 16 states, from $6.73 in Kansas to $266.79 in California.
- States publishing
- 16
- National median
- $25.88per 15 min
- Lowest
- $6.73Kansas
- Highest
- $266.79California
- Median per hour
- $103.5216 time-based states
What does Medicaid pay for G0316?
16 state Medicaid programs publish a fee-for-service rate for G0316. The national median is $25.88 per 15 min. California pays the most, $266.79 per 15 min, and Kansas the least, $6.73 per 15 min, a 39.6x spread. Converted to an hour of service in the 16 states that bill it by time, the median is $103.52 per hour.
Medicare (non-facility, 2026 physician fee schedule): $32.65–$41.81 depending on the state's Medicare locality.
G0316 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 16 states with every variant, modifier and effective date.
Frequently asked questions
What does Medicaid pay for G0316?
It depends on the state. Of the 16 states with a published fee-for-service rate, the median is $25.88 per 15 min. California pays the most ($266.79 per 15 min) and Kansas the least ($6.73 per 15 min).
Which state pays the highest Medicaid rate for G0316?
California, at $266.79 per 15 min ($1,067.16 per hour), effective 2026-07-01.
Do managed-care plans pay the same rate for G0316?
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.