Medicaid To Medicare / Primary Care Pay Bump


As more women enter Medicaid, and as more people on Medicaid cannot find a doctor, states have an important role to play in improving women’s access to primary care. 

Medicaid to Medicare parity (or the primary care pay bump) boosts patients’ access to health care by reimbursing Medicaid physicians at Medicare rates for a designated set of E&M and vaccine administration codes.  

Absent these reforms, Medicaid pays only a fraction of what Medicare pays for similar care in most states, leaving women covered, but vulnerable without access to ob-gyn care.

The federal version of this program, which expired in 2014 showed promise in boosting access to patients’ access to physicians, but did not include ob-gyns. 

Now states are leading the way for reform. 

As 19 states and DC work to continue the primary care pay bump in their own budgets, it is important that women’s health care must be part of the equation.

Help get YOUR state on board so that Medicaid-insured women and their doctors are not left behind.  Every state, including YOURS, can raise Medicaid primary care rates to Medicare levels for ob-gyns.

Together, ACOG and our Fellows are going ALL-IN FOR WOMEN’S PRIMARY CARE. 


View ACOG’s webinar on-demand, led by ACOG President Dr. Mark DeFrancesco, MD, MBA.  You’ll hear from experts in Georgia, Mississippi, and South Carolina about how they were able to extend the primary care pay bump and succeeded in expanding the pay bump to include ob-gyns.

Want to get your state engaged?

Click here for a state advocacy toolkit.

 How does your state pay?

Click here to see how much ground your state needs to make up to treat women's primary care equally.

Ob-Gyns As Primary Care Providers:

Click here to find out if your state recognize ob-gyns as primary care providers in other parts of your Medicaid program.

Ready to spread the word?

Take Action

Sign this petition to your state lawmakers asking them to adequately fund women’s primary care services within Medicaid.

Talking Points

Click here
 for talking points on why ob-gyns are primary care providers.

Fact Sheets

If your state has extended, or is strongly considering extending the program, click here to download a customizable one-pager.

(AL, CA, CO, CT, DE, DC, GA, HI, IA, IN, ME, MD, MI, MS, MO, NE, NV, NM, OH, SC, WA)

If your state hasn't extended the program, click here to download a customizable one-pager.

(AZ, AR, FL, ID, IL, KS, KT, LA, MA, MN, NH, NJ, NY, NC, OR, PA, RI, SD, TN, TX, UT, VT, VA, WV, WI)

If your state is not listed in either category, then its Medicaid program has historically paid at or near Medicare rates for primary care services.  Your state has already achieved parity!


Stay Connected

Are you interested in getting updates on progress in the states and new resources to help you go all-in?  Click here to join our email list serv.

Media Materials

Click here to view ACOG print ads.

Click here to view a template for an OpEd.

Twitter and online media graphics




23 Percent 

@ACOGAction: 68.4k impressions in January 2015 










Evergreen Tweets:

More than 68% of adult Medicaid beneficiaries are women. Support the #MedicaidFix. #WomenToo

Medicaid expansion may cover 7 mil. more women. Will they be able to find a doctor? #MedicaidFix #WomenToo

We must extend the Medicaid payment parity program and expand to #obgyns. #MedicaidFix #WomenToo

New Ideas:

35 state Medicaid programs classify #obgyns as primary care providers. Does yours? #MedicaidFix #WomenToo

Primary care services that #obgyns provide include screening, evaluation, counseling, immunizations #MedicaidFix #WomenToo

An #obgyn is often the only doctor a woman sees on a regular basis #MedicaidFix #WomenToo

The #Medicaid Primary Care Pay Bump program allows physicians to see more Medicaid patients #MedicaidFix #WomenToo

ACTION: Extend the primary care bump and expand it to include women’s health #obgyn #MedicaidFix #WomenToo

Let’s include #WomenToo in the primary care bump and extension #MedicaidFix

American Congress of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188 | Mailing Address: PO Box 70620, Washington, DC 20024-9998