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J1730 Medicaid reimbursement rates by state

Injection, diazoxide, up to 300 mg. 13 state Medicaid programs publish a fee-for-service rate for J1730 at the physician psychologist level. Rates run from $65.30 in Wisconsin to $690.03 in Maine, with a median of $112.09.

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

States publishing
13
Median rate
$112.09units vary by state
Highest
$690.03Maine
Medicare (non-facility)
—not on the physician fee schedule

J1730 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
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$690.03⚠ over 3× mediansince 2017-01-01——Not classified—MaineCare Fee Schedule (MaineCare UCR, H
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$123.87since 2013-07-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$118.56since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$117.96since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$116.48since 2003-02-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$112.16since 2021-01-01——Plans negotiate; applies out of network—HCA Professional administered drugs fee
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$112.09since 2020-03-01——Plans must pay at least this—NC Medicaid fee schedule 'Nurse Midwives
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$112.01since 2005-01-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$111.85since 2007-01-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$111.85since 2026-01-01——Not classified—Maryland Medicaid Professional Services
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$111.85since 2007-01-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$107.38since 2025-09-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$65.30since 2005-10-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-

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 J1730?

It depends on the state. Of the 13 states with a published fee-for-service rate, the median is $112.09. Maine pays the most ($690.03) and Wisconsin the least ($65.30).

Which state pays the highest Medicaid rate for J1730?

Maine, at $690.03, effective 2017-01-01.

Do managed-care plans pay the same rate for J1730?

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 J1730 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
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