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J0699 Medicaid reimbursement rates by state

Injection, cefiderocol, 10 mg. 20 state Medicaid programs publish a fee-for-service rate for J0699 at the physician psychologist level. Rates run from $1.88 in New Jersey to $2.59 in Indiana, with a median of $2.54.

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

States publishing
20
Median rate
$2.54units vary by state
Highest
$2.59Indiana
Medicare (non-facility)
—not on the physician fee schedule

J0699 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
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$2.59since 2026-04-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$2.56since 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)$2.56since 2026-10-01——Plans negotiate; applies out of network—ODM provider-administered pharmaceutical
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$2.56since 2026-10-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$2.55since 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)$2.55since 2026-07-01——Plans negotiate; applies out of network—Medi-Cal Physician-Administered Drug Rat
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$2.55since 2026-07-01——Plans negotiate; applies out of network—MDHHS Practitioner and Medical Clinic Fe
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$2.55since 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)$2.55since 2026-07-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$2.54since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$2.54since 2026-07-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$2.48since 2026-10-01——Not classified—Q1/Q2/Q3/Q4 2026 PAD Fee Schedule
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$2.42since 2026-01-01——Not classified—CMAP fee schedule: Physician Office and
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$2.42since 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)$2.42since 2026-01-01——Not classified—Maryland Medicaid Professional Services
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$2.42since 2026-08-25——Not classified—Physician Drug Fee Schedule (REF-0130-Q)
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$2.35since 2025-10-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$2.12since 2024-03-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$1.98since 2021-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Nurse Practiti
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$1.88since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS

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 J0699?

It depends on the state. Of the 20 states with a published fee-for-service rate, the median is $2.54. Indiana pays the most ($2.59 per unit) and New Jersey the least ($1.88).

Which state pays the highest Medicaid rate for J0699?

Indiana, at $2.59 per unit, effective 2026-04-01.

Do managed-care plans pay the same rate for J0699?

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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