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C9254 Medicaid reimbursement rates by state

Injection, lacosamide, 1 mg. 7 state Medicaid programs publish a fee-for-service rate for C9254 at the physician psychologist level. Rates run from $0.00 in Arkansas to $0.52 in Texas, with a median of $0.21.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
7
Median rate
$0.21units vary by state
Highest
$0.52Texas
Medicare (non-facility)
—not on the physician fee schedule

C9254 rate in every state

One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$0.52since 2026-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$0.38since 2020-08-01——Plans negotiate; applies out of network—AHCCCS Arizona Health Care Cost Containm
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$0.29since 2026-07-01——Plans negotiate; applies out of network—Medi-Cal Physician-Administered Drug Rat
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$0.21since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$0.18since 2018-09-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$0.09since 2026-04-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
ArkansasPhysician or licensed psychologist (incl. BCBA-D) · Arkansas Medicaid (fee-for-service)$0.00since 2025-06-13——Not classified—Arkansas Medicaid Physician / CRNA / Fam

Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Frequently asked questions

What does Medicaid pay for C9254?

It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $0.21. Texas pays the most ($0.52) and Arkansas the least ($0.00).

Which state pays the highest Medicaid rate for C9254?

Texas, at $0.52, effective 2026-09-01.

Do managed-care plans pay the same rate for C9254?

Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The table shows the rule for each state, cited to the contract or statute.

Related Pharmacy codes

Track C9254 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
Medicaid rates by state