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πŸ“–Methodology
βš–οΈCompare States
by Concourse

Data: CMS T-MSIS 2018-2024

Source: opendata.hhs.gov

Updated: Oct 20, 2026

Rate Benchmarks

What each state pays for the same procedure. Start from a code β€” no need to pick a state first.

High-spend codes billed in 20+ states

Restricted to widely-billed codes: a procedure billed in four states cannot tell you whether your rate is unusual.

T1019Personal care ser per 15 minT1015Clinic serviceT2016Habil res waiver per diem99213Office o/p est low 20 minS5125Attendant care service /15m99214Office o/p est mod 30 min99284Emergency dept visit mod mdmH2016Comp comm supp svc, per diem99283Emergency dept visit low mdmH2015Comp comm supp svc, 15 min99285Emergency dept visit hi mdm90837Psytx w pt 60 minutesS5102Adult day care per diem90834Psytx w pt 45 minutesT2021Day habil waiver per 15 minH2017Psysoc rehab svc, per 15 minT1017Targeted case managementT1020Personal care ser per diem90999Unlisted dialysis procedureA0427Als1-emergencyH2019Ther behav svc, per 15 min92507Tx sp lang voice comm indivT2033Res, nos waiver per diemT1000Private duty/independent nsgH2014Skills train and dev, 15 minH0020Alcohol and/or drug services; methadone administration and/or serviceH0004Behavioral health counseling and therapy, per 15 minutes97530Therapeutic activitiesA0429Bls-emergencyH0019Behavioral health; long-term residential (non-medical, non-acute care in aS9124Nursing care, in the home; b97153Adaptive behavior tx by tech97110Therapeutic exercisesT2023Targeted case mgmt per monthT1016Case managementS5130Homaker service nos per 15mH2036A/d tx program, per diemG0463Hospital outpt clinic visitH0036Comm psy face-face per 15minT2031Assist living waiver/diem
99213Office o/p est low 20 minPhysician & Surgical

Average paid per claim across 51 reporting states. National median $46.40. Maryland pays $77.26, 67% above the median.

State-by-state detail is in the table below.

Ranked by rate
Coverage differs across these states. Claims represent 44% of Montana’s Medicaid spending but only 5% of Georgia’s. A lower figure here may reflect what this dataset cannot see rather than what the state spends.
StateAvg paid / claimvs medianClaimsProvidersCoverage
AK β€” Alaska$262.13+465%1,934,00048737%
SD β€” South Dakota$104.29+125%1,685,68134535%
ND β€” North Dakota$96.93+109%1,078,27520927%
CO β€” Colorado$95.61+106%9,374,5442,60231%
HI β€” Hawaii$88.45+91%2,191,44371817%
NM β€” New Mexico$83.74+80%5,815,17194331%
KS β€” Kansas$83.46+80%3,349,8731,06530%
MD β€” Maryland$77.26+67%12,537,7583,31021%
UT β€” Utah$74.30+60%2,281,2201,35916%
NY β€” New York$72.59+56%83,900,82019,23129%
MN β€” Minnesota$68.23+47%9,686,0231,21324%
OK β€” Oklahoma$66.69+44%6,765,7691,80120%
NE β€” Nebraska$66.16+43%3,220,3617079%
GA β€” Georgia$64.96+40%5,094,4759235%
SC β€” South Carolina$64.90+40%10,855,6952,78219%
MO β€” Missouri$56.70+22%8,463,8034,37435%
MA β€” Massachusetts$56.23+21%15,565,1625,35237%
MS β€” Mississippi$56.11+21%9,494,7961,93321%
VA β€” Virginia$54.72+18%14,662,6004,04226%
RI β€” Rhode Island$52.65+13%2,819,0342,05335%
OR β€” Oregon$51.17+10%7,365,1001,6159%
DC β€” District of Columbia$49.70+7%1,993,67132527%
IN β€” Indiana$47.65+3%18,833,2592,39515%
MI β€” Michigan$47.52+2%24,849,4764,77628%
NC β€” North Carolina$46.93+1%19,545,6684,20224%
NV β€” Nevada$46.40βˆ’0%5,796,0562,51322%
AZ β€” Arizona$46.07βˆ’1%16,106,7872,81127%
NJ β€” New Jersey$45.39βˆ’2%23,768,5014,47836%
MT β€” Montana$44.48βˆ’4%2,315,58753644%
WA β€” Washington$43.51βˆ’6%12,698,1031,89514%
OH β€” Ohio$43.03βˆ’7%38,412,3885,17323%
FL β€” Florida$41.78βˆ’10%24,326,2336,08417%
AL β€” Alabama$41.52βˆ’11%8,891,6031,99721%
ID β€” Idaho$40.98βˆ’12%3,162,90567915%
TX β€” Texas$38.90βˆ’16%36,238,0456,08427%
DE β€” Delaware$38.60βˆ’17%2,599,39454522%
PA β€” Pennsylvania$37.62βˆ’19%13,276,9928,96816%
WI β€” Wisconsin$36.81βˆ’21%8,269,7441,78015%
TN β€” Tennessee$34.97βˆ’25%21,356,4724,08426%
WV β€” West Virginia$34.30βˆ’26%9,164,0231,28624%
WY β€” Wyoming$33.73βˆ’27%511,86525919%
CT β€” Connecticut$32.71βˆ’30%25,510,5281,73141%
KY β€” Kentucky$32.13βˆ’31%30,914,1403,39623%
NH β€” New Hampshire$31.91βˆ’31%1,743,33540540%
AR β€” Arkansas$28.46βˆ’39%5,442,4661,76619%
LA β€” Louisiana$25.46βˆ’45%26,094,4903,26520%
IA β€” Iowa$24.21βˆ’48%8,391,7881,33323%
IL β€” Illinois$23.30βˆ’50%23,870,29514,31511%
ME β€” Maine$19.99βˆ’57%3,133,95149138%
VT β€” Vermont$19.00βˆ’59%1,487,98432324%
CA β€” California$14.42βˆ’69%124,469,95714,70417%

Average paid per claim is a ratio internal to the claims data, so unlike per-enrollee measures it needs no external denominator. It remains subject to one caveat: this extract carries no claim-type field, so fee-for-service claims and managed-care encounter records are mixed together, and states derive encounter amounts inconsistently. The coverage column indicates how much of each state’s program these claims represent.