Medicaid-to-Medicare Fee Index
This data is presented as an interactive tool that allows users to: filter by timeframe/year, select specific data columns (distributions), filter by state or geography, and view the data as a table, map, or trend chart.
2024
Location All Services Primary Care Obstetric Care Other Services
United States 0.75 0.66 0.88 0.84 Alabama 0.92 0.78 1.21 0.93 Alaska 1.3 1.3 1.29 1.32 Arizona 0.98 0.76 1.38 1.07 Arkansas 0.76 0.59 0.7 1.32 California 0.67 0.56 0.85 0.81 Colorado 0.83 0.81 0.82 0.89 Connecticut 0.79 0.66 1.14 0.68 Delaware 0.96 0.96 0.93 0.99 District of Columbia 0.81 0.81 0.81 0.82 Florida 0.64 0.56 0.82 0.73 Georgia 0.83 0.73 0.92 1.02 Hawaii 0.84 0.8 1.01 0.7 Idaho 0.94 0.97 0.9 0.9 Illinois 0.63 0.47 0.8 0.85 Indiana 0.96 1 0.85 1.01 Iowa 0.77 0.62 0.82 1.12 Kansas 0.69 0.55 0.78 0.99 Kentucky 0.69 0.54 0.95 0.91 Louisiana 0.64 0.6 0.66 0.72 Maine 0.78 0.84 0.7 0.71 Maryland 0.95 1.02 0.89 0.81 Massachusetts 0.74 0.64 0.94 0.74 Michigan 0.76 0.73 0.88 0.66 Minnesota 0.74 0.76 0.67 0.76 Mississippi 0.93 0.94 0.89 0.91 Missouri 0.86 0.86 0.83 0.92 Montana 1.32 1.32 1.31 1.33 Nebraska 1.01 0.69 1.17 1.68 Nevada 0.9 0.84 0.98 0.97 New Hampshire 0.73 0.61 1 0.71 New Jersey 0.61 0.48 0.89 0.56 New Mexico 1.21 1.21 1.2 1.21 New York 0.76 0.68 0.83 0.88 North Carolina 0.82 0.78 0.82 0.96 North Dakota 1.06 1.06 1.05 1.07 Ohio 0.63 0.56 0.67 0.78 Oklahoma 0.94 0.94 0.93 0.95 Oregon 0.88 0.78 1.18 0.74 Pennsylvania 0.68 0.49 1.06 0.7 Rhode Island 0.52 0.57 0.4 0.54 South Carolina 0.89 0.86 1.07 0.9 South Dakota 0.91 0.79 1.05 1.07 Tennessee N/A N/A N/A N/A Texas 0.63 0.52 0.75 0.86 Utah 0.8 0.76 0.87 0.82 Vermont 0.87 0.87 0.87 0.87 Virginia 0.83 0.74 0.97 0.87 Washington 0.64 0.56 0.83 0.56 West Virginia 0.82 0.76 0.97 0.74 Wisconsin 0.66 0.56 0.65 0.95 Wyoming 1 1.03 0.98 0.97
2019
Location All Services Primary Care Obstetric Care Other Services
United States 0.72 0.67 0.8 0.77 Alabama 0.84 0.81 0.9 0.83 Alaska 1.1 1.1 1.1 1.1 Arizona 0.82 0.73 0.95 0.88 Arkansas 0.79 0.64 0.7 1.34 California 0.73 0.76 0.61 0.73 Colorado 0.81 0.84 0.69 0.91 Connecticut 0.75 0.75 0.82 0.69 Delaware 0.98 0.98 0.94 1.01 District of Columbia 0.8 0.8 0.8 0.8 Florida 0.58 0.49 0.79 0.66 Georgia 0.83 0.71 0.96 0.97 Hawaii 0.62 0.53 0.65 0.84 Idaho 0.93 0.97 0.9 0.9 Illinois 0.59 0.44 0.87 0.78 Indiana 0.77 0.74 1.06 0.75 Iowa 0.81 0.71 0.84 1.08 Kansas 0.71 0.61 0.75 0.94 Kentucky 0.76 0.65 0.94 0.9 Louisiana 0.69 0.66 0.66 0.8 Maine 0.66 0.63 0.66 0.76 Maryland 0.9 0.94 0.88 0.8 Massachusetts 0.78 0.71 0.94 0.73 Michigan 0.69 0.62 0.91 0.57 Minnesota 0.74 0.77 0.68 0.74 Mississippi 0.92 0.94 0.9 0.9 Missouri 0.62 0.57 0.6 0.8 Montana 1.11 1.07 1.2 1.09 Nebraska 1.05 0.9 1.08 1.46 Nevada 0.96 0.95 1 0.92 New Hampshire 0.57 0.55 0.58 0.62 New Jersey 0.5 0.51 0.47 0.53 New Mexico 0.93 0.91 0.98 0.95 New York 0.57 0.43 0.75 0.71 North Carolina 0.78 0.78 0.68 0.92 North Dakota 1 1 1 1 Ohio 0.62 0.57 0.66 0.72 Oklahoma 0.94 0.94 0.94 0.94 Oregon 0.83 0.73 1.12 0.7 Pennsylvania 0.68 0.46 1.11 0.67 Rhode Island 0.37 0.32 0.4 0.51 South Carolina 0.98 0.99 1.36 0.84 South Dakota 0.85 0.71 0.91 1.14 Tennessee N/A N/A N/A N/A Texas 0.65 0.58 0.72 0.8 Utah 0.81 0.76 0.91 0.8 Vermont 0.86 0.89 0.82 0.81 Virginia 0.78 0.7 0.89 0.83 Washington 0.69 0.63 0.92 0.57 West Virginia 0.71 0.58 1.03 0.66 Wisconsin 0.62 0.47 0.65 0.99 Wyoming 0.96 0.9 1.09 0.95
Notes
The Medicaid-to-Medicare fee index measures each state's physician fees relative to Medicare fees in each state. The Medicaid data are based on surveys sent by the Urban Institute to the forty-nine states and the District of Columbia that have a fee-for-service (FFS) component in their Medicaid programs (only Tennessee does not). These fees represent only those payments made under FFS Medicaid. The Medicare-to-Medicaid fee index is a computed ratio of the Medicaid fee for each service in each state to the Medicare fee for the same services. Comparable Medicare fees are calculated using relative value units, geographic adjusters, and conversion factor.
This table presents the Medicaid-to-Medicare fee index using the services and weights in use in 2019. National data are weighted by 2019 state Medicaid enrollment for both years.
Sources
Laura Skopec, Avani Pugazhendhi, and Stephen Zuckerman, "Updated Medicaid-To-Medicare Fee Index: Medicaid Physician Fees Still Lag Behind Medicare Physician Fees ," Urban Institute, May 2025.
Definitions
Primary Care : defined as services subject to the Affordable Care Act's Medicaid primary care parity provision.
N/A : Not applicable because Tennessee does not have a Medicaid fee-for-service program.