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J1600 Medicaid reimbursement rates by state

Injection, gold sodium thiomalate, up to 50 mg. 16 state Medicaid programs publish a fee-for-service rate for J1600 at the physician psychologist level. Rates run from $7.86 in North Carolina to $438.08 in Arizona, with a median of $27.71.

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

States publishing
16
Median rate
$27.71units vary by state
Highest
$438.08Arizona
Medicare (non-facility)
—not on the physician fee schedule

J1600 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
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$438.08⚠ over 3× mediansince 2024-04-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$31.96since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$30.15since 2013-09-01——Plans negotiate; applies out of network—ODM provider-administered pharmaceutical
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$30.15since 2023-01-01——Plans negotiate; applies out of network—MDHHS Practitioner and Medical Clinic Fe
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$30.15since 2013-07-01——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)$30.15since 2013-07-01——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)$30.15since 2014-07-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$28.45since 2021-04-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$26.97since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$25.98since 2012-07-01——Not classified—SCDHHS Infusion Center Fee Schedule (sch
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$22.79since 2021-01-01——Plans negotiate; applies out of network—HCA Professional administered drugs fee
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$13.69since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$13.61since 2013-07-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$12.53since 2026-01-01——Not classified—Maryland Medicaid Professional Services
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$11.65since 2025-06-13——Not classified—Arkansas Medicaid Nurse Practitioner Fee
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$7.86since 2020-03-01——Plans must pay at least this—NC Medicaid fee schedule 'Nurse Midwives

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 J1600?

It depends on the state. Of the 16 states with a published fee-for-service rate, the median is $27.71. Arizona pays the most ($438.08) and North Carolina the least ($7.86).

Which state pays the highest Medicaid rate for J1600?

Arizona, at $438.08, effective 2024-04-01.

Do managed-care plans pay the same rate for J1600?

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

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