J1612 Medicaid reimbursement rates by state

Injection, glucagon (gvoke), 0.01 mg. 25 state Medicaid programs publish a fee-for-service rate for J1612 at the physician psychologist level. Rates run from $1.62 in Arizona to $2.65 in Indiana, with a median of $1.80.

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

States publishing: 25
Median rate: $1.80units vary by state
Highest: $2.65Indiana
Medicare (non-facility): —not on the physician fee schedule

J1612 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.

State	Medicaid rate	Unit	Per hour	Managed-care plans	% of Medicare	Source
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)	$2.65since 2025-10-01	unit	—	Plans must pay at least this	—	IHCP Professional Fee Schedule (Last Upd
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)	$2.52since 2026-07-01	—	—	Plans negotiate; applies out of network	—	2026 Fee Schedule - Covered Procedures R
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)	$2.50since 2026-01-01	—	—	Not classified	—	NJMMIS Procedure Master Listing CPTHCPCS
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)	$2.37since 2026-07-01	—	—	Plans must pay at least this	—	DOM Comprehensive Fee Schedule, Septembe
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)	$2.37since 2026-04-01	—	—	Not classified	—	Maryland Medicaid Professional Services
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)	$2.30since 2026-04-01	—	—	Plans negotiate; applies out of network	—	HFS Practitioner Fee Schedule (effective
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)	$1.80since 2026-07-01	—	—	Plans negotiate; applies out of network	—	Medi-Cal Physician-Administered Drug Rat
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)	$1.80since 2026-07-01	—	—	Not classified	—	Montana Healthcare Programs fee schedule
WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health)	$1.80since 2026-10-01	—	—	Not classified	—	Wyoming Medicaid Downloadable Fee Schedu
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)	$1.80since 2026-07-01	—	—	Plans negotiate; applies out of network	—	Utah Medicaid Coverage and Reimbursement
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)	$1.80since 2026-08-01	—	—	Plans negotiate; applies out of network	—	NC Medicaid fee schedule 'Physician Admi
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)	$1.80since 2026-07-01	—	—	Plans negotiate; applies out of network	—	ODM provider-administered pharmaceutical
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)	$1.80since 2026-07-01	—	—	Plans negotiate; applies out of network	—	MDHHS Child and Adolescent Health Center
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)	$1.80since 2026-07-01	—	—	Plans negotiate; applies out of network	—	ForwardHealth max fee schedule: Medical-
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)	$1.80since 2026-07-01	—	—	Plans negotiate; applies out of network	—	SCDHHS Nurse Midwives Fee Schedule (sche
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)	$1.80since 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)	$1.80since 2026-09-01	—	—	Plans must pay at least this	—	Physician Administered Drug (PAD) Pricin
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)	$1.80since 2026-07-01	—	—	Plans negotiate; applies out of network	—	RI Medicaid Interactive Fee For Service
South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services)	$1.80since 2026-07-01	—	—	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)	$1.80since 2026-07-01	0.01 MG	—	Plans negotiate; applies out of network	—	BMS Physician Administered Drug ASP Pric
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)	$1.79since 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)	$1.79since 2026-07-01	—	—	Plans negotiate; applies out of network	—	MHCP Fee Schedule - Current Fee Schedule
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)	$1.79since 2026-07-01	—	—	Plans negotiate; applies out of network	—	DMAS procedure fee file hcpcmedical.csv
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)	$1.74since 2026-07-01	—	—	Not classified	—	Q1/Q2/Q3/Q4 2026 PAD Fee Schedule
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)	$1.62since 2026-08-01	—	—	Plans negotiate; applies out of network	—	AHCCCS FFS Capped Fee Schedule: Physicia

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 J1612?

It depends on the state. Of the 25 states with a published fee-for-service rate, the median is $1.80. Indiana pays the most ($2.65 per unit) and Arizona the least ($1.62).

Which state pays the highest Medicaid rate for J1612?

Indiana, at $2.65 per unit, effective 2025-10-01.

Do managed-care plans pay the same rate for J1612?

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

90714Vaccines and immune globulins · 47 states 90740Vaccines and immune globulins · 46 states 90656Vaccines and immune globulins · 45 states 90658Vaccines and immune globulins · 45 states 90651Vaccines and immune globulins · 44 states 90653Physician-administered drugs (J-codes) · 44 states 90662Physician-administered drugs (J-codes) · 44 states 90747Physician-administered drugs (J-codes) · 44 states 90673Physician-administered drugs (J-codes) · 43 states 90620Vaccines and immune globulins · 42 states 90621Vaccines and immune globulins · 42 states Q0112All potassium hydroxide (koh) preparations · 42 states

Track J1612 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.

Start free trial Pricing