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J0911 Medicaid reimbursement rates by state

Instillation, taurolidine 1.35 mg and heparin sodium 100.... 21 state Medicaid programs publish a fee-for-service rate for J0911 at the physician psychologist level. Rates run from $5.64 in Oklahoma to $9.50 in Arkansas, with a median of $8.33.

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

States publishing
21
Median rate
$8.33units vary by state
Highest
$9.50Arkansas
Medicare (non-facility)
—not on the physician fee schedule

J0911 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
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$9.50since 2025-05-16——Not classified—Arkansas Medicaid Home Health Fee Schedu
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$9.00since 2024-07-15——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Physician Admi
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$8.92since 2024-10-01——Plans negotiate; applies out of network—ODM provider-administered pharmaceutical
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$8.90since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$8.75since 2024-07-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$8.50since 2026-01-01——Not classified—Maryland Medicaid Professional Services
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$8.33since 2025-01-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$8.33since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$8.33since 2025-01-01——Plans negotiate; applies out of network—PADL- Appendix A -Published Copy - Janua
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$8.33since 2024-07-01——Plans negotiate; applies out of network—HCA Professional administered drugs fee
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$8.33since 2024-07-01——Plans negotiate; applies out of network—MHCP Fee Schedule (Wayback capture 20250
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$8.33since 2024-07-01——Not classified—Q1/Q2/Q3/Q4 2024 PAD Fee Schedule
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$8.33since 2024-07-01——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$8.33since 2024-07-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$8.33since 2024-07-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$8.33since 2024-07-01——Plans negotiate; applies out of network—2026 Fee Schedule - Covered Procedures R
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$8.25since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$8.20since 2025-01-01——Plans must pay at least this—Physician Administered Drug (PAD) Pricin
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$7.50since 2026-08-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$5.74since 2025-10-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$5.64since 2026-07-01——State sets the plan rate—SoonerCare Title XIX Fee Schedule

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 J0911?

It depends on the state. Of the 21 states with a published fee-for-service rate, the median is $8.33. Arkansas pays the most ($9.50) and Oklahoma the least ($5.64).

Which state pays the highest Medicaid rate for J0911?

Arkansas, at $9.50, effective 2025-05-16.

Do managed-care plans pay the same rate for J0911?

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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