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J0602 Medicaid reimbursement rates by state

Sevelamer carbonate (renvela or therapeutically equivalent). 15 state Medicaid programs publish a fee-for-service rate for J0602 at the physician psychologist level. Rates run from $0.01 in District of Columbia to $0.57 in New Jersey, with a median of $0.02.

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

States publishing
15
Median rate
$0.02units vary by state
Highest
$0.57New Jersey
Medicare (non-facility)
—not on the physician fee schedule

J0602 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 JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$0.57⚠ over 3× mediansince 2026-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$0.45⚠ over 3× mediansince 2025-01-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$0.38⚠ over 3× mediansince 2025-01-01——Plans must pay at least this—Physician Administered Drug (PAD) Pricin
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$0.07since 2026-07-17——Plans negotiate; applies out of network—Rates for Dialysis Treatments and Home D
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$0.05since 2025-07-01——Plans negotiate; applies out of network—2026 Fee Schedule - Covered Procedures R
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$0.04since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$0.03since 2026-08-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$0.02since 2026-07-01——Plans negotiate; applies out of network—Medi-Cal Physician-Administered Drug Rat
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$0.02since 2026-04-01——Plans negotiate; applies out of network—ODM provider-administered pharmaceutical
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$0.01since 2026-07-01——Plans negotiate; applies out of network—HCA Kidney centers fee schedule (kidneyc
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$0.01since 2025-10-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$0.01since 2025-01-01——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$0.01since 2025-01-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$0.01since 2025-01-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
District of ColumbiaAny qualified provider (rate does not vary by provider) · DC Medicaid (DHCF) fee-for-service$0.01since 2025-04-01——Not classified—REFRP00178CSV - Medical Fee Schedule Rep

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 J0602?

It depends on the state. Of the 15 states with a published fee-for-service rate, the median is $0.02. New Jersey pays the most ($0.57) and District of Columbia the least ($0.01).

Which state pays the highest Medicaid rate for J0602?

New Jersey, at $0.57, effective 2026-01-01.

Do managed-care plans pay the same rate for J0602?

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

Track J0602 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
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