J1411 Medicaid reimbursement rate by state (2026)
Injection, etranacogene dezaparvovec-drlb. Medicaid pays a median of $3,500,000.00 for J1411 across 11 states, from $34,440.00 in South Carolina to $3,675,000.00 in Indiana.
- States publishing
- 11
- National median
- $3,500,000.00units vary by state
- Lowest
- $34,440.00South Carolina
- Highest
- $3,675,000.00Indiana
What does Medicaid pay for J1411?
11 state Medicaid programs publish a fee-for-service rate for J1411. The national median is $3,500,000.00 (units differ between states). Indiana pays the most, $3,675,000.00 per unit, and South Carolina the least, $34,440.00, a 106.7x spread.
J1411 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 11 states with every variant, modifier and effective date.
Frequently asked questions
What does Medicaid pay for J1411?
It depends on the state. Of the 11 states with a published fee-for-service rate, the median is $3,500,000.00. Indiana pays the most ($3,675,000.00 per unit) and South Carolina the least ($34,440.00).
Which state pays the highest Medicaid rate for J1411?
Indiana, at $3,675,000.00 per unit, effective 2023-06-01.
Do managed-care plans pay the same rate for J1411?
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.