In a nutshell:

Most outsourced Medicaid billing partners charge 1.5% to 3% of collected revenue, so for a 50-client agency billing $40,000–$80,000 per week, expect to pay between $600 and $2,400 weekly depending on claim volume, complexity, and services included.

The (slightly) longer version:

Outsourced Medicaid billing costs are typically structured as a percentage of collections, meaning you only pay when your agency gets paid. Rates can vary based on your state, the number of payers or waivers you bill, your documentation process, and how much support you need (e.g., payment posting, eligibility checks, denial management).

Typical Cost Breakdown for a 50-Client Agency

Assuming $800–$1,600 per client per week in Medicaid-authorized care:

• Weekly Medicaid billing: $40,000–$80,000
• Billing cost at 1.5%: $600–$1,200/week
• Billing cost at 3.0%: $1,200–$2,400/week

What’s usually included in the fee?

It's important to note that many billing services, especially those built within scheduling software services, only facilitate basic claim submission. A true outsourced Medicaid billing service includes:

• Claims submission and tracking
• Denial resolution and resubmissions
• EVV + visit-to-claim reconciliation
• Payment posting and remittance matching
• Weekly AR reports and collections support

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Pro Tip: The cheapest option isn’t always the best. Missed authorizations, denials, or delays can cost far more than a slightly higher billing fee.

Reminder: This information is not legal advice, not a guarantee, and not a substitute for checking in with your state’s Medicaid authorities and plans directly. Read our full disclaimer here.