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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
99214Office o/p est mod 30 minPhysician & Surgical

Average paid per claim across 51 reporting states. National median $62.03. Indiana pays $62.85, 1% 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$173.07+179%1,173,35544437%
ND β€” North Dakota$98.93+59%727,92017027%
OK β€” Oklahoma$94.36+52%5,518,1181,72420%
MD β€” Maryland$92.31+49%12,350,7163,69321%
NY β€” New York$90.54+46%33,483,01016,66729%
NM β€” New Mexico$89.84+45%5,263,34197431%
HI β€” Hawaii$89.82+45%1,818,04869817%
CO β€” Colorado$89.67+45%7,989,8952,73331%
UT β€” Utah$84.20+36%2,291,1461,34116%
SC β€” South Carolina$79.56+28%7,685,1342,49619%
MN β€” Minnesota$76.74+24%9,291,3711,18824%
SD β€” South Dakota$75.11+21%770,67126035%
DC β€” District of Columbia$74.95+21%1,319,97631427%
NE β€” Nebraska$74.46+20%2,019,5796029%
MT β€” Montana$72.06+16%1,666,99154144%
VA β€” Virginia$70.03+13%14,132,0533,54526%
RI β€” Rhode Island$69.98+13%1,843,3601,74335%
MI β€” Michigan$68.71+11%18,465,0794,38828%
OR β€” Oregon$68.45+10%6,869,6801,5209%
MO β€” Missouri$67.62+9%6,026,8493,21335%
MA β€” Massachusetts$66.73+8%15,882,9065,07937%
GA β€” Georgia$66.29+7%3,052,1468235%
NJ β€” New Jersey$64.19+3%13,094,6253,81436%
NV β€” Nevada$63.49+2%4,910,7012,28522%
IN β€” Indiana$62.85+1%15,220,8032,13015%
NC β€” North Carolina$62.03βˆ’0%19,487,0464,46024%
OH β€” Ohio$60.96βˆ’2%28,041,2024,59423%
KS β€” Kansas$60.53βˆ’2%1,982,60888830%
WA β€” Washington$59.38βˆ’4%11,674,5161,86014%
ID β€” Idaho$57.70βˆ’7%2,060,90362315%
AL β€” Alabama$56.83βˆ’8%7,068,5922,00621%
PA β€” Pennsylvania$56.02βˆ’10%9,996,3918,24416%
CT β€” Connecticut$54.77βˆ’12%19,262,8541,60141%
AZ β€” Arizona$54.08βˆ’13%19,507,2993,07827%
MS β€” Mississippi$53.23βˆ’14%6,164,7371,69021%
WY β€” Wyoming$52.50βˆ’15%337,28322619%
FL β€” Florida$52.18βˆ’16%17,233,3296,46817%
DE β€” Delaware$51.73βˆ’17%2,283,66950522%
WV β€” West Virginia$50.10βˆ’19%4,614,5881,04524%
NH β€” New Hampshire$48.53βˆ’22%1,922,56941840%
IL β€” Illinois$48.35βˆ’22%14,896,91214,78411%
TX β€” Texas$46.91βˆ’24%19,295,3475,84827%
AR β€” Arkansas$45.02βˆ’27%4,401,4741,54719%
KY β€” Kentucky$44.07βˆ’29%13,736,6462,51223%
LA β€” Louisiana$42.07βˆ’32%17,137,0942,93020%
TN β€” Tennessee$41.84βˆ’33%18,206,3363,80026%
WI β€” Wisconsin$41.62βˆ’33%8,056,2331,65415%
CA β€” California$37.50βˆ’40%60,407,53113,43817%
IA β€” Iowa$36.24βˆ’42%4,584,8771,08323%
VT β€” Vermont$34.00βˆ’45%1,388,21732224%
ME β€” Maine$30.57βˆ’51%2,879,48047038%

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.