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J1290 Medicaid reimbursement rates by state

Injection, ecallantide, 1 mg. 38 state Medicaid programs publish a fee-for-service rate for J1290 at the physician psychologist level. Rates run from $45.03 in Connecticut to $5,849.24 in New Hampshire, with a median of $595.94.

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

States publishing
38
Median rate
$595.94units vary by state
Highest
$5,849.24New Hampshire
Medicare (non-facility)
—not on the physician fee schedule

J1290 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
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$5,849.24⚠ over 3× mediansince 2026-07-01——Plans negotiate; applies out of network—2026 Fee Schedule - Covered Procedures R
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$671.57since 2026-10-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$618.43since 2026-09-01——Plans must pay at least this—Physician Administered Drug (PAD) Pricin
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$614.17since 2026-04-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$599.62since 2026-10-01——Plans negotiate; applies out of network—PADL Fee Schedule -Published Copy - Octo
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$599.62since 2026-10-01——Plans negotiate; applies out of network—ODM provider-administered pharmaceutical
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$599.62since 2026-10-01——Plans negotiate; applies out of network—HCA Professional administered drugs fee
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$599.62since 2026-10-01——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$599.62since 2026-10-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services)$599.62since 2026-10-01——Not classified—South Dakota Medicaid Drugs and Biologic
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$599.62since 2026-10-011 MG—Plans negotiate; applies out of network—BMS Physician Administered Drug ASP Pric
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$595.94since 2026-07-01——Plans negotiate; applies out of network—Medi-Cal Physician-Administered Drug Rat
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$595.94since 2026-08-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$595.94since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$595.94since 2026-07-01——Plans negotiate; applies out of network—MDHHS Practitioner and Medical Clinic Fe
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$595.94since 2026-07-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$595.94since 2026-07-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$595.94since 2026-07-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$595.94since 2026-07-01——State sets the plan rate—SoonerCare Title XIX Fee Schedule
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$595.94since 2026-07-01——Not classified—MaineCare Section 90 - Drug Rates/Fee Sc
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$595.94since 2026-07-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$579.83since 2026-10-01——Not classified—Q1/Q2/Q3/Q4 2026 PAD Fee Schedule
MontanaPhysician or licensed psychologist (incl. BCBA-D) · Montana Medicaid and HMK Plus (fee-for-service)$579.75since 2026-01-01——Not classified—Montana Healthcare Programs fee schedule
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$579.75since 2026-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$579.75since 2026-01-01——Not classified—Maryland Medicaid Professional Services
District of ColumbiaAny qualified provider (rate does not vary by provider) · DC Medicaid (DHCF) fee-for-service$579.75since 2026-04-01——Not classified—REFRP00178CSV - Medical Fee Schedule Rep
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$578.75since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$578.75since 2026-08-25——Not classified—Physician Drug Fee Schedule (REF-0130-Q)
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$563.12since 2026-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$563.10since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$550.97since 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - HCPCS (i
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$544.79since 2024-03-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$539.86since 2023-01-01——Plans negotiate; applies out of network—SCDHHS Nurse Midwives Fee Schedule (sche
WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health)$520.23since 2022-10-01——Not classified—Wyoming Medicaid Downloadable Fee Schedu
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$500.90since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$262.69since 2022-01-01——Plans must pay at least this—NC Medicaid fee schedule 'Nurse Practiti
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$262.35since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$45.03since 2026-01-01——Not classified—CMAP fee schedule: Physician Office and

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 J1290?

It depends on the state. Of the 38 states with a published fee-for-service rate, the median is $595.94. New Hampshire pays the most ($5,849.24) and Connecticut the least ($45.03).

Which state pays the highest Medicaid rate for J1290?

New Hampshire, at $5,849.24, effective 2026-07-01.

Do managed-care plans pay the same rate for J1290?

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.

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