J0752 Medicaid reimbursement rate by state (2026)
Oral, lenacapavir, 300 mg, fda approved prescription. Medicaid pays a median of $617.95 for J0752 across 27 states, from $426.58 in Vermont to $812.50 in New Hampshire.
- States publishing
- 27
- National median
- $617.95units vary by state
- Lowest
- $426.58Vermont
- Highest
- $812.50New Hampshire
What does Medicaid pay for J0752?
27 state Medicaid programs publish a fee-for-service rate for J0752. The national median is $617.95 (units differ between states). New Hampshire pays the most, $812.50, and Vermont the least, $426.58, a 1.9x spread.
J0752 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 27 states with every variant, modifier and effective date.
Frequently asked questions
What does Medicaid pay for J0752?
It depends on the state. Of the 27 states with a published fee-for-service rate, the median is $617.95. New Hampshire pays the most ($812.50) and Vermont the least ($426.58).
Which state pays the highest Medicaid rate for J0752?
New Hampshire, at $812.50, effective 2026-07-01.
Do managed-care plans pay the same rate for J0752?
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 workspace shows the rule for each state, cited to the contract or statute.