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J1180 Medicaid reimbursement rates by state

Injection, dyphylline, up to 500 mg. 12 state Medicaid programs publish a fee-for-service rate for J1180 at the physician psychologist level. Rates run from $3.84 in Idaho to $9.10 in Iowa, with a median of $8.05.

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

States publishing
12
Median rate
$8.05units vary by state
Highest
$9.10Iowa
Medicare (non-facility)
—not on the physician fee schedule

J1180 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
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$9.10since 2013-07-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$8.55since 2003-10-01——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)$8.53since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$8.30since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$8.16since 2021-01-01——Plans negotiate; applies out of network—HCA Professional administered drugs fee
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$8.05since 2005-07-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$8.05since 2005-10-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$8.05since 2006-07-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$8.05since 2023-01-01——Not classified—MaineCare Section 90 - Drug Rates/Fee Sc
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$5.49since 2026-07-01——Not classified—Health First Colorado Physician Fee Sche
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$4.89since 2024-04-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$3.84since 2025-09-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju

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 J1180?

It depends on the state. Of the 12 states with a published fee-for-service rate, the median is $8.05. Iowa pays the most ($9.10) and Idaho the least ($3.84).

Which state pays the highest Medicaid rate for J1180?

Iowa, at $9.10, effective 2013-07-01.

Do managed-care plans pay the same rate for J1180?

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 J1180 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
Medicaid rates by state