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J1094 Medicaid reimbursement rates by state

Injection, dexamethasone acetate, 1 mg. 7 state Medicaid programs publish a fee-for-service rate for J1094 at the physician psychologist level. Rates run from $0.14 in Michigan to $0.86 in Illinois, with a median of $0.24.

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

States publishing
7
Median rate
$0.24units vary by state
Highest
$0.86Illinois
Medicare (non-facility)
—not on the physician fee schedule

J1094 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
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$0.86⚠ over 3× mediansince 2010-02-01——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)$0.71since 2013-07-01——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)$0.53since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$0.24since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$0.22since 2022-01-01——Plans must pay at least this—NC Medicaid fee schedule 'Local Health D
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$0.22since 2024-04-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$0.14since 2023-01-01——Plans negotiate; applies out of network—MDHHS Child and Adolescent Health Center

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 J1094?

It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $0.24. Illinois pays the most ($0.86) and Michigan the least ($0.14).

Which state pays the highest Medicaid rate for J1094?

Illinois, at $0.86, effective 2010-02-01.

Do managed-care plans pay the same rate for J1094?

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

Track J1094 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
Medicaid rates by state