J0215 Medicaid reimbursement rates by state
Injection, alefacept, 0.5 mg. 5 state Medicaid programs publish a fee-for-service rate for J0215 at the physician psychologist level. Rates run from $25.44 in North Carolina to $44.14 in New Mexico, with a median of $39.56.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 5
- Median rate
- $39.56units vary by state
- Highest
- $44.14New Mexico
- Medicare (non-facility)
- —not on the physician fee schedule
J0215 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.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $44.14since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $41.64since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Practitioner and Medical Clinic Fe |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $39.56since 2024-04-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Physicia |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $30.07since 2013-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $25.44since 2022-01-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Local Health D |
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 J0215?
It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $39.56. New Mexico pays the most ($44.14) and North Carolina the least ($25.44).
Which state pays the highest Medicaid rate for J0215?
New Mexico, at $44.14, effective 2025-01-01.
Do managed-care plans pay the same rate for J0215?
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.