J1729 Medicaid reimbursement rates by state
Injection, hydroxyprogesterone caproate. 15 state Medicaid programs publish a fee-for-service rate for J1729 at the physician psychologist level. Rates run from $3.12 in Ohio to $18.18 in Maine, with a median of $14.57.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 15
- Median rate
- $14.57units vary by state
- Highest
- $18.18Maine
- Medicare (non-facility)
- —not on the physician fee schedule
J1729 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 |
|---|---|---|---|---|---|---|
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $18.18since 2024-01-01 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $18.10since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| ArkansasPhysician or licensed psychologist (incl. BCBA-D) · Arkansas Medicaid (fee-for-service) | $17.57since 2025-06-13 | — | — | Not classified | — | Arkansas Medicaid Physician / CRNA / Fam |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $16.64since 2024-02-01 | — | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Physician Admi |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $15.72since 2022-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $15.16since 2023-01-01 | — | — | Not classified | — | SCDHHS Infusion Center Fee Schedule (sch |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $15.16since 2024-04-01 | — | — | Plans must pay at least this | — | Physician Administered Drug (PAD) Pricin |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $14.57since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $13.82since 2023-10-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $13.64since 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) | $13.63since 2023-07-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $11.40since 2024-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Professional administered drugs fee |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $5.35since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $5.02since 2025-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $3.12since 2018-01-01 | — | — | Plans negotiate; applies out of network | — | ODM provider-administered pharmaceutical |
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 J1729?
It depends on the state. Of the 15 states with a published fee-for-service rate, the median is $14.57. Maine pays the most ($18.18) and Ohio the least ($3.12).
Which state pays the highest Medicaid rate for J1729?
Maine, at $18.18, effective 2024-01-01.
Do managed-care plans pay the same rate for J1729?
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.