J0575 Medicaid reimbursement rates by state
Buprenorphine/naloxone, oral. 22 state Medicaid programs publish a fee-for-service rate for J0575 at the physician psychologist level. Rates run from $3.97 in Minnesota to $52.75 in Iowa, with a median of $14.55.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 22
- Median rate
- $14.55units vary by state
- Highest
- $52.75Iowa
- Medicare (non-facility)
- —not on the physician fee schedule
J0575 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 |
|---|---|---|---|---|---|---|
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $52.75⚠ over 3× mediansince 2018-09-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $36.45since 2026-08-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Physicia |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $28.49since 2021-01-01 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $20.53since 2025-07-01 | One Dose | — | Plans must pay at least this | — | Specialized Behavioral Health Services f |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $20.19since 2022-04-01 | — | — | Plans negotiate; applies out of network | — | ODM provider-administered pharmaceutical |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $17.58since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $17.45since 2025-07-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $16.61since 2019-01-01 | unit | — | Plans negotiate; applies out of network | — | OHP FFS behavioral health fee schedule ( |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $15.52since 2017-04-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $14.93since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $14.67since 2025-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $14.43since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | SCDHHS Nurse Midwives Fee Schedule (sche |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $14.43since 2026-09-01 | — | — | Plans must pay at least this | — | Physician Administered Drug (PAD) Pricin |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $10.11since 2026-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, Septembe |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $7.98since 2023-07-01 | — | — | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $7.50since 2022-07-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $6.80since 2026-07-01 | — | — | State sets the plan rate | — | SoonerCare Title XIX Fee Schedule |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $5.00since 2026-10-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $4.73since 2025-07-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $4.24since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Professional administered drugs fee |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $4.20since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Physician-Administered Drug Rat |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $3.97since 2026-06-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
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 J0575?
It depends on the state. Of the 22 states with a published fee-for-service rate, the median is $14.55. Iowa pays the most ($52.75) and Minnesota the least ($3.97).
Which state pays the highest Medicaid rate for J0575?
Iowa, at $52.75, effective 2018-09-01.
Do managed-care plans pay the same rate for J0575?
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.
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Track J0575 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.