J0801 Medicaid reimbursement rate by state (2026)
Injection, corticotropin (acthar gel), up to 40 units. Medicaid pays a median of $4,133.45 for J0801 across 33 states, from $3,605.07 in Idaho to $4,899.56 in Indiana.
- States publishing
- 33
- National median
- $4,133.45units vary by state
- Lowest
- $3,605.07Idaho
- Highest
- $4,899.56Indiana
What does Medicaid pay for J0801?
33 state Medicaid programs publish a fee-for-service rate for J0801. The national median is $4,133.45 (units differ between states). Indiana pays the most, $4,899.56 per unit, and Idaho the least, $3,605.07, a 1.4x spread.
J0801 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 33 states with every variant, modifier and effective date.
Frequently asked questions
What does Medicaid pay for J0801?
It depends on the state. Of the 33 states with a published fee-for-service rate, the median is $4,133.45. Indiana pays the most ($4,899.56 per unit) and Idaho the least ($3,605.07).
Which state pays the highest Medicaid rate for J0801?
Indiana, at $4,899.56 per unit, effective 2026-04-01.
Do managed-care plans pay the same rate for J0801?
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.