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Billing code J1595 · Pharmacy

J1595 Medicaid reimbursement rate by state (2026)

Injection, glatiramer acetate, 20 mg. Medicaid pays a median of $67.64 for J1595 across 23 states, from $10.53 in Kansas to $237.13 in Oklahoma.

Data as of Oct 5, 202623 statesEvery rate links to its official source

States publishing
23
National median
$67.64units vary by state
Lowest
$10.53Kansas
Highest
$237.13Oklahoma
Answer

What does Medicaid pay for J1595?

23 state Medicaid programs publish a fee-for-service rate for J1595. The national median is $67.64 (units differ between states). Oklahoma pays the most, $237.13, and Kansas the least, $10.53, a 22.5x spread.

State ranking

J1595 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 23 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Oklahoma Source · since 2026-07-01$237.13——State sets the plan rate—
2Texas Source · since 2018-10-01$183.95——Plans negotiate; applies out of network—
3Nevada Source · since 2024-04-01$177.46——Plans must pay at least this—
11Wisconsin Source · since 2009-01-01$67.64——Plans negotiate; applies out of network—
12Maryland Source · since 2026-01-01$67.64——Not classified—
13Nebraska Source · since 2026-07-01$66.75——Plans negotiate; applies out of network—
22District of Columbia Source · since 2017-01-01$28.62——Not classified—
23Kansas Source · since 2004-01-01$10.53——Not classified—
See all 23 states for J1595 — start free

15 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

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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; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track J1595 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
FAQ

Frequently asked questions

What does Medicaid pay for J1595?

It depends on the state. Of the 23 states with a published fee-for-service rate, the median is $67.64. Oklahoma pays the most ($237.13) and Kansas the least ($10.53).

Which state pays the highest Medicaid rate for J1595?

Oklahoma, at $237.13, effective 2026-07-01.

Do managed-care plans pay the same rate for J1595?

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.