Ask what New Hampshire pays for Medicaid and you’ll get a “depends.” There’s no single statewide rate. What the state pays hinges on the service, the procedure code, who’s billing, and when the rate went into effect. And then there’s how the claim gets paid. Fee-for-service runs off the state’s fee schedule. Managed care runs through the health plan, and its rates can be different.

Everything lives on the New Hampshire Medicaid MMIS Health Enterprise Portal. The fee schedules are all posted there: covered procedures, manually priced items, dental, DME, hospital outpatient, nursing facility, FQHC/RHC, MAT, OTP, hospice, and the DRG materials. Which one you open depends on the billing question in front of you, since they don’t answer the same thing.

That changes the question worth asking. Skip “What does NH Medicaid pay?” and ask which rate schedule fits the service you’re billing. Comparing New Hampshire with other states? The Medicaid reimbursement rates by state breakdown lines them up for you.

Table of Contents

Is There One New Hampshire Medicaid Reimbursement Rate?

No. The state runs several reimbursement systems side by side.

Professional and physician fee schedules
Hospital inpatient and outpatient methodologies
Nursing facility per-diem rates
Dental fee schedules
Behavioral health payments
DME and medical supplies
FQHC and RHC payments
MAT and OTP services
Hospice
Ambulance and transportation
Manually priced services
Supplemental and directed payments

The portal keeps current schedules apart from archived ones, so the effective date deserves your attention before anything else. Pull a rate from an old schedule and you’re quoting history, not the current NH Medicaid payment.

Where Can You Find the Official NH Medicaid Fee Schedule?

Start at the NH MMIS Health Enterprise Portal, in the Documents and Forms/Fee Schedules section. Right now the portal lists 2026 materials:

A covered procedure report with service authorization requirements, manually priced items, a July 2026 nursing-facility rate file, SFY 2027 hospital outpatient rates, dental procedures, FQHC/RHC, MAT, OTP and DRG materials. Files get updated periodically. Older ones land in the archived documents.

How to Look Up an NH Medicaid CPT or HCPCS Rate

Work through it in this order:

Identify the service and CPT, HCPCS or CDT code.
Determine the provider and service category.
Open the applicable current NH Medicaid fee schedule.
Check the schedule’s effective date.
Look for service-authorization or prior-authorization requirements.
Check applicable modifiers, units and billing rules.
Determine whether the claim is FFS or managed care.

Chasing a single dollar figure is the weaker approach. Setting, modifiers and billing circumstances can change the payment rules for the same general service, and one number hides every bit of that.

New Hampshire Medicaid Reimbursement Rates by Provider Type

Physician and Professional Services

Physician reimbursement follows rule codes and the professional fee schedule that applies. Confirm the CPT/HCPCS code, modifier, effective date and any authorization requirement before you estimate a payment.

The schedule gives you the state rate. The amount on a processed claim can still land somewhere else.

Hospital Reimbursement

Inpatient and outpatient hospital care aren’t paid the same way. New Hampshire posts hospital outpatient rate information, and the portal has Outpatient Rates – Hospital & Hospital Based RHCs SFY 2027 right next to the DRG pricing and relative-weight materials.

Inpatient claims can be paid on a DRG basis, while outpatient services follow their own rate methodologies. Hospital reimbursement rarely boils down to one CPT fee.

Nursing Facility Rates

Nursing facilities depart furthest from a simple statewide fee schedule. The state publishes facility-specific rates with monthly and per-diem figures, built from factors such as facility information, resident acuity and Minimum Data Set (MDS) information.

The July 2026 NH MMIS materials include a revised nursing-facility Appendix A rate file. The better question for a facility is “What is this facility’s applicable Medicaid rate?” and not “What is New Hampshire’s nursing-home rate?”

If you’re helping a family plan long-term care, eligibility comes first. The New Hampshire Medicaid income limits for 2026 and how to apply guide covers that side.

Dental Services

Dental pay is tied to the exact procedure. The portal has a 2026 covered dental procedures fee schedule, effective January 1, 2026. Before you work out what you’ll be paid, check the CDT code, what’s covered, whether the service needs prior authorization, and the date the rate applies from.

Behavioral Health

Behavioral health got its own treatment for 2026–2027. CMS signed off on a New Hampshire directed payment that adds a flat dollar amount to qualifying outpatient behavioral health services for the rating period running July 1, 2026 to June 30, 2027. It gets built into managed care capitation as a separate payment term.

Fee schedules and managed care payment mechanisms both shape what published reimbursement looks like. This is a clean example.

DME

CMS has also signed off on a New Hampshire minimum fee schedule for durable medical equipment covering the July 1, 2026 to June 30, 2027 rating period. The state doesn’t pay it as a separate line item. Instead, the money is folded into managed care capitation through a risk-based rate adjustment.

DME providers check two things: the state requirements and the payment arrangement governing the claim.

FQHCs and RHCs

The portal lists an FQHC-RHC fee schedule effective July 1, 2026. These clinics often follow payment methodologies that differ from ordinary professional billing, so use the FQHC/RHC schedule and its rules.

MAT, OTP and Hospice

Three more services have 2026 fee schedules on the portal:

Medication Assisted Treatment (MAT)
Opioid Treatment Programs (OTP)
Hospice

MAT and OTP are effective July 1, 2026. Hospice carries FY 2027 rate information.

NH Medicaid Fee-for-Service vs Medicaid Care Management

New Hampshire Medicaid runs both fee-for-service and Medicaid Care Management arrangements.

A state fee schedule won’t always match the exact payment on a managed-care claim. Verify against the plan.

State-directed payments sit inside New Hampshire’s managed-care system too. CMS approved both the 2026–2027 behavioral-health and DME arrangements covered above.

Why Can an NH Medicaid Payment Differ From the Fee Schedule?

The number in the fee schedule and the number on your remittance don’t always match. A long list of factors drives the gap:

Provider type
CPT, HCPCS or CDT code
Modifiers
Number of units
Prior authorization
Service authorization
Place of service (POS)
Claim circumstances
Manually priced items
Managed-care contracts
Supplemental or directed payments
Effective-date changes

Chasing a discrepancy? Put the processed claim, the remittance information and the payment rules in front of you together. One fee-schedule figure won’t explain the whole payment.

2026–2027 New Hampshire Medicaid Rate Changes

A handful of current developments make this stretch worth tracking.

The MMIS portal lists the 2026 and SFY 2027 materials. CMS documents the managed-care directed payments on its own.

Worth knowing: a published 2027 hospital outpatient schedule doesn’t mean every New Hampshire Medicaid rate for 2027 is final.

How Often Does New Hampshire Medicaid Update Rates?

There’s no single update date. Schedules take effect on January 1, July 1, October 1, federal fiscal-year dates or service-specific dates, and the portal’s current and archived listings show exactly that spread. A search for “NH Medicaid rates 2026” only gets you started. Match the exact code, schedule and date to your claim.

FAQs About New Hampshire Medicaid Reimbursement Rates

What are the current New Hampshire Medicaid reimbursement rates?

There’s no single statewide rate. Reimbursement varies by service, procedure code, provider type and payment methodology, and the NH MMIS portal publishes the schedules and rate documents.

Where can I find the NH Medicaid fee schedule?

On the NH MMIS Health Enterprise Portal, in the Fee Schedules section. Current and archived schedules for numerous Medicaid services live there.

How do I look up an NH Medicaid CPT code?

Find the current schedule for your code, check its effective date, then review the authorization, modifier and billing requirements.

Does NH Medicaid have a separate HCPCS fee schedule?

Yes. NH Medicaid publishes covered procedure and manually priced information that can include HCPCS-related services.

Which schedule you use depends on the service and provider category.

Are NH Medicaid rates the same for every provider?

No. Provider type, service, procedure code, facility, payment methodology, authorization requirements and FFS versus managed care all change what a provider gets paid.

Does the NH Medicaid fee schedule apply to managed care?

Not the same way for every service. Managed care payment runs through MCO contracts and state-directed payments, so check the MCO rules for the service you’re billing.

How are New Hampshire nursing facility rates calculated?

Facility by facility. Rate-setting draws on facility information and resident acuity, and the state publishes the facility-specific rates through NH MMIS.

What are the 2027 New Hampshire Medicaid reimbursement rates?

Some SFY 2027 materials are out already, including hospital outpatient rates and FY 2027 hospice information. Other rates have their own publication and effective dates.

Why is my Medicaid payment different from the published rate?

Coding, modifiers, units, authorization, provider type, place of service and managed-care arrangements all shape the final claim. Treat the fee schedule as the starting point.

Does New Hampshire Medicaid require prior authorization?

For some services, yes. The current NH MMIS covered-procedure materials identify which services carry service-authorization requirements.

Conclusion

Don’t expect one dollar figure from New Hampshire Medicaid. It’s really a pile of separate schedules, one per type of service. Start at the NH MMIS portal and find your code. Check the date the rate took effect. Then work out whether the claim runs through fee-for-service or a managed care plan, because until you know that, whatever number you’re looking at might not apply.

The 2026–2027 changes reach hospital outpatient, nursing facilities, DME, behavioral health, MAT, OTP, FQHC/RHC, and hospice. CMS-approved directed payments pile on extra layers that a standard fee schedule won’t show you. Check back often, because these numbers keep moving.

Official Resources

Disclaimer: Medicaid rates and payment rules change often. Before you bill or make any financial decision, confirm the current figures with NH MMIS, New Hampshire DHHS, CMS, or the managed care plan that handles your claim.

Naseer

About Naseer

Naseer has 10+ years of experience creating informative content and researching medicare topics. He focuses on simplifying Medicaid and benefits details to support readers find clear, reliable, and easy-to-understand guidance.

New Hampshire Medicaid Reimbursement Rates 2026–2027: Guide