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J0120 Medicaid reimbursement rates by state

Injection, tetracycline, up to 250 mg. 11 state Medicaid programs publish a fee-for-service rate for J0120 at the physician psychologist level. Rates run from $0.05 in Washington to $16.71 in New Mexico, with a median of $7.82.

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

States publishing
11
Median rate
$7.82units vary by state
Highest
$16.71New Mexico
Medicare (non-facility)
—not on the physician fee schedule

J0120 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
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$16.71since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$15.10since 2026-01-01——Not classified—Maryland Medicaid Professional Services
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$13.77since 2025-06-13——Not classified—Arkansas Medicaid Nurse Practitioner Fee
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$11.88since 2013-07-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$9.85since 2001-04-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$7.82since 2005-10-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$5.49since 2010-02-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$4.71since 1996-01-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$0.86since 2024-04-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$0.73since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$0.05since 2022-07-01——Plans negotiate; applies out of network—HCA Professional administered drugs fee

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 J0120?

It depends on the state. Of the 11 states with a published fee-for-service rate, the median is $7.82. New Mexico pays the most ($16.71) and Washington the least ($0.05).

Which state pays the highest Medicaid rate for J0120?

New Mexico, at $16.71, effective 2025-01-01.

Do managed-care plans pay the same rate for J0120?

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

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