Published June 2026 | Compiled by Brian Werfel, Esq.

The 2026 updated Medicaid Fee for Service Rate and Crossover Payment surveys have been released. The survey provides an opportunity for a quick reference on fee for service Medicaid rates across the country. While many find it useful as an immediate practical tool in the billing office, it is also an important reference for company and state association leaders to use when crafting and supporting initiatives to improve Medicaid reimbursement. The wide variety of approaches and corresponding rates can provide support for state regulatory and legislative initiatives. It is always helpful to be able to point out comparators to strive toward. Whether you are looking for a one-time adjustment to a specific billing code, or a wholesale change in payment such as tying rates to Medicare, there is evidence in the chart to support your ask.

Medicaid reimbursement rates and policies will undoubtedly be a high priority for ambulance services and state budget writers in the coming legislative session. With the uncertainty around state Medicaid programs in the wake of numerous federal policy shifts it is imperative to understand the full context of how all states are paying for Medicaid covered ground ambulance services.  H.R 1, the OBBBA, mandated new Medicaid work requirements, shorter 6-month eligibility, reduce retroactivity, and restricted coverage for legal immigrants. These changes are but a few of the factors that are leading states to make significant changes to Medicaid programs. Additionally, this survey does not include any payment amount for participation in supplemental Medicaid programs such as provider taxes and GEMT. Three states, Indiana, Maine, and West Virginia are noted to be expressly tied to the Medicare ambulance fee schedule.

The Medicaid Crossover survey indicates which states are paying the full Medicare coinsurance amount and those that only cover to the extent that Medicare payment is less than the Medicaid allowable amount. This survey provides a very high-level look however it must be noted that there are substantial variables within each state Medicaid crossover coverage. The survey does not breakout specific Medicaid populations that may have different rules such as QMB, expansion, and SLMB for example.

The combined data of the fee for service rate information and crossover payment policy gives you an important tool as you move ahead with your state Medicaid legislative priorities. Whether it is defending an approach you are fortunate to enjoy, or, more likely, aggressively pursuing much needed increases in Medicaid payment these tools will serve you well.

The rates set out in this survey are based on publicly available information provided by the various state Medicaid agencies.  While the AAA has taken steps to verify the accuracy of the information on this Survey, it is possible that the rates provided in the Survey may not reflect changes to a state’s reimbursement policies that have not been made publicly available.  These rates may also not reflect any emergency budgetary measures or other temporary reductions imposed by a state.

The AAA’s goal is to make this survey as accurate as possible.  Therefore, if you believe the rates for your state are inaccurate, please contact hello@ambulance.org for assistance.