J1426 Medicaid reimbursement rate by state (2026)
Injection, casimersen, 10 mg. Medicaid pays a median of $161.60 for J1426 across 29 states, from $148.83 in Illinois to $185.26 in Montana.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 29
- National median
- $161.60units vary by state
- Lowest
- $148.83Illinois
- Highest
- $185.26Montana
What does Medicaid pay for J1426?
29 state Medicaid programs publish a fee-for-service rate for J1426 at the physician psychologist level. The national median is $161.60 (units differ between states). Montana pays the most, $185.26, and Illinois the least, $148.83, a 1.2x spread.
J1426 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 29 states with every variant, modifier and effective date.
Frequently asked questions
What does Medicaid pay for J1426?
It depends on the state. Of the 29 states with a published fee-for-service rate, the median is $161.60. Montana pays the most ($185.26) and Illinois the least ($148.83).
Which state pays the highest Medicaid rate for J1426?
Montana, at $185.26, effective 2025-07-01.
Do managed-care plans pay the same rate for J1426?
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.