J0475 Medicaid reimbursement rate by state (2026)
Injection, baclofen, 10 mg. Medicaid pays a median of $186.11 for J0475 across 40 states, from $0.27 in New Hampshire to $223.13 in New Jersey.
- States publishing
- 40
- National median
- $186.11units vary by state
- Lowest
- $0.27New Hampshire
- Highest
- $223.13New Jersey
What does Medicaid pay for J0475?
40 state Medicaid programs publish a fee-for-service rate for J0475. The national median is $186.11 (units differ between states). New Jersey pays the most, $223.13, and New Hampshire the least, $0.27, a 826.4x spread.
J0475 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 40 states with every variant, modifier and effective date.
Frequently asked questions
What does Medicaid pay for J0475?
It depends on the state. Of the 40 states with a published fee-for-service rate, the median is $186.11. New Jersey pays the most ($223.13) and New Hampshire the least ($0.27).
Which state pays the highest Medicaid rate for J0475?
New Jersey, at $223.13, effective 2025-01-01.
Do managed-care plans pay the same rate for J0475?
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 workspace shows the rule for each state, cited to the contract or statute.