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J0613 Medicaid reimbursement rates by state

Injection, calcium gluconate (wg critical care). 32 state Medicaid programs publish a fee-for-service rate for J0613 at the physician psychologist level. Rates run from $0.04 in Kansas to $0.20 in Iowa, with a median of $0.05.

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

States publishing
32
Median rate
$0.05units vary by state
Highest
$0.20Iowa
Medicare (non-facility)
—not on the physician fee schedule

J0613 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
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$0.20⚠ over 3× mediansince 2024-03-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$0.16⚠ over 3× mediansince 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$0.13since 2023-04-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$0.11since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$0.09since 2026-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$0.09since 2026-01-01——Not classified—Maryland Medicaid Professional Services
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$0.09since 2026-01-01——Not classified—CMAP fee schedule: Physician Office and
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$0.08since 2023-04-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$0.08since 2025-06-04——Not classified—Arkansas Medicaid Certified Nurse-Midwif
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$0.08since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$0.07since 2026-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$0.07since 2026-07-0110 MG—Plans negotiate; applies out of network—KY Medicaid Renal Dialysis fee schedule
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$0.07since 2026-08-25——Not classified—Physician Drug Fee Schedule (REF-0130-Q)
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$0.07since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$0.05since 2026-07-01——Not classified—Montana Healthcare Programs fee schedule
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$0.05since 2026-07-01——Plans negotiate; applies out of network—Medi-Cal Physician-Administered Drug Rat
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$0.05since 2026-08-01——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Physician Admi
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$0.05since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$0.05since 2026-07-01——Plans negotiate; applies out of network—MDHHS Practitioner and Medical Clinic Fe
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$0.05since 2026-07-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$0.05since 2026-07-01——Not classified—SCDHHS Infusion Center Fee Schedule (sch
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$0.05since 2026-07-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$0.05since 2026-07-01——State sets the plan rate—SoonerCare Title XIX Fee Schedule
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$0.05since 2026-09-01——Plans must pay at least this—Physician Administered Drug (PAD) Pricin
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$0.05since 2026-07-01——Not classified—MaineCare Fee Schedule (MaineCare UCR, H
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$0.041since 2026-10-0110 MG—Plans negotiate; applies out of network—BMS Physician Administered Drug ASP Pric
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$0.04since 2026-10-01——Plans negotiate; applies out of network—PADL Fee Schedule -Published Copy - Octo
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$0.04since 2026-10-01——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$0.04since 2026-10-01——Plans negotiate; applies out of network—HCA Professional administered drugs fee
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$0.04since 2026-10-01——Not classified—Q1/Q2/Q3/Q4 2026 PAD Fee Schedule
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$0.04since 2026-10-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$0.04since 2026-10-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched

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 J0613?

It depends on the state. Of the 32 states with a published fee-for-service rate, the median is $0.05. Iowa pays the most ($0.20) and Kansas the least ($0.04).

Which state pays the highest Medicaid rate for J0613?

Iowa, at $0.20, effective 2024-03-01.

Do managed-care plans pay the same rate for J0613?

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

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