J0570 Medicaid reimbursement rates by state
Buprenorphine implant, 74.2 mg. 10 state Medicaid programs publish a fee-for-service rate for J0570 at the physician psychologist level. Rates run from $0.00 in California to $4,512.50 in North Carolina, with a median of $1,285.99.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 10
- Median rate
- $1,285.99units vary by state
- Highest
- $4,512.50North Carolina
- Medicare (non-facility)
- —not on the physician fee schedule
J0570 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 |
|---|---|---|---|---|---|---|
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $4,512.50⚠ over 3× mediansince 2017-01-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Nurse Midwives |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $1,390.45since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $1,311.75since 2021-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Professional administered drugs fee |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $1,311.75since 2022-01-01 | — | — | Paid by the state, outside plans | — | MDHHS PIHP/CMHSP Physician Injectable Dr |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $1,311.75since 2023-10-01 | unit | — | Plans negotiate; applies out of network | — | OHP FFS behavioral health fee schedule ( |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $1,260.23since 2026-01-20 | — | — | Not classified | — | Arkansas Medicaid Nurse Practitioner Fee |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $1,237.50since 2024-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Physicia |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $1,237.50since 2022-01-01 | — | — | Plans negotiate; applies out of network | — | Copy of PADL- Appendix A Published Copy_ |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $309.25since 2025-10-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $0.00since 2025-10-01 | — | — | Plans negotiate; applies out of network | — | Medi Cal Physician Administered Drug Rat |
Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 J0570?
It depends on the state. Of the 10 states with a published fee-for-service rate, the median is $1,285.99. North Carolina pays the most ($4,512.50) and California the least ($0.00).
Which state pays the highest Medicaid rate for J0570?
North Carolina, at $4,512.50, effective 2017-01-01.
Do managed-care plans pay the same rate for J0570?
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.