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J1602 Medicaid reimbursement rates by state

Injection, golimumab, 1 mg, for intravenous use. 38 state Medicaid programs publish a fee-for-service rate for J1602 at the physician psychologist level. Rates run from $10.05 in Idaho to $76.63 in New Hampshire, with a median of $11.04.

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

States publishing
38
Median rate
$11.04units vary by state
Highest
$76.63New Hampshire
Medicare (non-facility)
—not on the physician fee schedule

J1602 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)$76.63⚠ over 3× mediansince 2026-07-01——Plans negotiate; applies out of network—2026 Fee Schedule - Covered Procedures R
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$41.98since 2025-12-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$40.50⚠ over 3× mediansince 2024-05-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$28.87since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
ArkansasPhysician or licensed psychologist (incl. BCBA-D) · Arkansas Medicaid (fee-for-service)$27.28since 2025-06-13——Not classified—Arkansas Medicaid Physician / CRNA / Fam
WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health)$14.08since 2022-10-01——Not classified—Wyoming Medicaid Downloadable Fee Schedu
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$12.30since 2026-10-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$11.63since 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)$11.63since 2026-01-01——Not classified—Maryland Medicaid Professional Services
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$11.63since 2026-01-01——Not classified—CMAP fee schedule: Physician Office and
District of ColumbiaAny qualified provider (rate does not vary by provider) · DC Medicaid (DHCF) fee-for-service$11.63since 2026-04-01——Not classified—REFRP00178CSV - Medical Fee Schedule Rep
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$11.29since 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)$11.29since 2026-08-25——Not classified—Physician Drug Fee Schedule (REF-0130-Q)
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$11.04since 2026-07-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$11.04since 2026-08-01——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Ambulatory Inf
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$11.04since 2026-07-01——Not classified—SCDHHS Infusion Center Fee Schedule (sch
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$11.04since 2026-07-01——Not classified—Montana Healthcare Programs fee schedule
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$11.04since 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)$11.04since 2026-08-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$11.04since 2026-07-01——Plans negotiate; applies out of network—MDHHS Practitioner and Medical Clinic Fe
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$11.04since 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)$11.04since 2026-07-01——State sets the plan rate—SoonerCare Title XIX Fee Schedule
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$11.04since 2026-09-01——Plans must pay at least this—Physician Administered Drug (PAD) Pricin
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$11.04since 2026-07-01——Not classified—MaineCare Section 90 - Drug Rates/Fee Sc
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$11.03since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$11.03since 2025-10-01——Plans negotiate; applies out of network—MHCP Fee Schedule (Wayback capture 20260
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$11.03since 2026-07-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$10.98since 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)$10.98since 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$10.98since 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)$10.98since 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$10.98since 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)$10.98since 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)$10.98since 2026-10-011 MG—Plans negotiate; applies out of network—BMS Physician Administered Drug ASP Pric
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$10.62since 2026-10-01——Not classified—Q1/Q2/Q3/Q4 2026 PAD Fee Schedule
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$10.54since 2025-04-01——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)$10.49since 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - HCPCS (i
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$10.05since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju

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 J1602?

It depends on the state. Of the 38 states with a published fee-for-service rate, the median is $11.04. New Hampshire pays the most ($76.63) and Idaho the least ($10.05).

Which state pays the highest Medicaid rate for J1602?

New Hampshire, at $76.63, effective 2026-07-01.

Do managed-care plans pay the same rate for J1602?

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

Track J1602 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
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