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J1632 Medicaid reimbursement rates by state

Injection, brexanolone, 1 mg. 15 state Medicaid programs publish a fee-for-service rate for J1632 at the physician psychologist level. Rates run from $73.31 in Nevada to $84.93 in Arkansas, with a median of $74.50.

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

States publishing
15
Median rate
$74.50units vary by state
Highest
$84.93Arkansas
Medicare (non-facility)
—not on the physician fee schedule

J1632 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
ArkansasPhysician or licensed psychologist (incl. BCBA-D) · Arkansas Medicaid (fee-for-service)$84.93since 2025-06-13——Not classified—Arkansas Medicaid Physician / CRNA / Fam
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$83.71since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$79.57since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$78.96since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$78.23since 2020-10-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$75.99since 2021-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$75.45since 2022-11-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$74.50since 2020-10-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$74.50since 2026-08-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$74.50since 2020-10-01——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$74.50since 2020-10-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$74.40since 2020-10-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$73.76since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$73.31since 2023-01-01——Plans negotiate; applies out of network—SCDHHS Nurse Midwives Fee Schedule (sche
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$73.31since 2024-04-01——Plans must pay at least this—Physician Administered Drug (PAD) Pricin

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 J1632?

It depends on the state. Of the 15 states with a published fee-for-service rate, the median is $74.50. Arkansas pays the most ($84.93) and Nevada the least ($73.31).

Which state pays the highest Medicaid rate for J1632?

Arkansas, at $84.93, effective 2025-06-13.

Do managed-care plans pay the same rate for J1632?

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 J1632 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
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