Market Grade · 2026 Edition
Best states to practice Internal Medicine, 2026
Internal Medicine commercial reimbursement is graded in 36 states this edition. Montana leads at grade A+: 1.80x Medicare on the specialty's own code basket, the 100th percentile among graded states.
36 states graded
top grade A+ (Montana)
frozen July 2026 · next edition 2027
The 2026 ranking
frozen 2026-07-15| # | State | Grade | vs Medicare | Percentile | Rate points | Confidence |
|---|---|---|---|---|---|---|
| 1 | Montana | A+ | 1.80x | 100 | 1,131 | High |
| 2 | Iowa | A+ | 1.74x | 97 | 813 | Medium |
| 3 | Tennessee | A | 1.68x | 94 | 834 | Medium |
| 4 | Minnesota | A | 1.56x | 91 | 5,542 | High |
| 5 | Wisconsin | A- | 1.48x | 89 | 8,014 | High |
| 6 | North Dakota | A- | 1.46x | 86 | 3,437 | High |
| 7 | New York | B+ | 1.36x | 83 | 2,027 | High |
| 8 | Vermont | B+ | 1.34x | 80 | 983 | Medium |
| 9 | North Carolina | B | 1.34x | 77 | 805 | Medium |
| 10 | South Dakota | B | 1.30x | 74 | 975 | Medium |
| 11 | Arkansas | B- | 1.28x | 71 | 704 | Medium |
| 12 | Colorado | B- | 1.22x | 69 | 6,344 | High |
| 13 | California | C+ | 1.21x | 66 | 51,599 | High |
| 14 | Wyoming | C+ | 1.19x | 63 | 636 | Medium |
| 15 | Washington | C+ | 1.15x | 60 | 10,672 | High |
| 16 | Illinois | C | 1.12x | 57 | 3,289 | High |
| 17 | Texas | C | 1.12x | 54 | 12,215 | High |
| 18 | Pennsylvania | C | 1.10x | 51 | 918 | Medium |
| 19 | Maine | C- | 1.08x | 49 | 2,333 | High |
| 20 | Michigan | C- | 1.08x | 46 | 1,699 | High |
| 21 | Alaska | C- | 1.06x | 43 | 818 | Medium |
| 22 | Connecticut | C- | 1.04x | 40 | 5,980 | High |
| 23 | Rhode Island | D | 1.02x | 37 | 588 | Medium |
| 24 | Alabama | D | 1.00x | 34 | 5,672 | High |
| 25 | Massachusetts | D | 0.98x | 31 | 2,283 | High |
| 26 | Ohio | D | 0.97x | 29 | 3,845 | High |
| 27 | Missouri | D | 0.95x | 26 | 905 | Medium |
| 28 | Delaware | F | 0.94x | 23 | 2,767 | High |
| 29 | Maryland | F | 0.94x | 20 | 343 | Medium |
| 30 | Georgia | F | 0.93x | 17 | 550 | Medium |
| 31 | Arizona | F | 0.91x | 14 | 6,251 | High |
| 32 | West Virginia | F | 0.90x | 11 | 1,478 | High |
| 33 | Virginia | F | 0.90x | 9 | 1,632 | High |
| 34 | Florida | F | 0.88x | 6 | 4,690 | High |
| 35 | Indiana | F | 0.87x | 3 | 931 | Medium |
| 36 | New Jersey | F | 0.85x | 0 | 506 | Medium |
Market Grade bands the within-specialty percentile of the state's median multiple-of-Medicare across the specialty's 12 highest-presence anchored codes (cell floor: 20 verified points per code, 40 percent basket coverage, minimum 3 codes). It grades commercial rate richness only in this edition; it is not demand, not cost of living, not quality. Grades are frozen; no trend claims exist in an inaugural edition. Method.
Documented reimbursement figures are modeled, not guaranteed. Derived from federally mandated Transparency in Coverage data (45 CFR 147.212). No PHI.
A grade is a market. Your contracts are the move.
Every grade above is computed from real contracted rates, not survey answers. What your own payer mix pays against these markets is what the Mirror shows for any NPI, free.
Cite this page
Source: Reddenda Practice Atlas, Internal Medicine, 2026 Edition. Reddenda. https://reddenda.health/practice-atlas/internal-medicine/
Derivation federally mandated TiC MRFs, verified to provider identity2026 Edition · 36 graded statesas of 2026-07-15 · methodology v1.0