J1738 Medicaid reimbursement rates by state
Injection, meloxicam, 1 mg. 14 state Medicaid programs publish a fee-for-service rate for J1738 at the physician psychologist level. Rates run from $1.00 in Kansas to $7.59 in California, with a median of $3.21.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 14
- Median rate
- $3.21units vary by state
- Highest
- $7.59California
- Medicare (non-facility)
- —not on the physician fee schedule
J1738 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 |
|---|---|---|---|---|---|---|
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $7.59since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $3.57since 2025-06-13 | — | — | Not classified | — | Arkansas Medicaid Nurse Practitioner Fee |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $3.38since 2020-10-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Nurse Practiti |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $3.34since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $3.32since 2023-07-01 | — | — | Plans negotiate; applies out of network | — | ODM provider-administered pharmaceutical |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $3.32since 2023-07-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Practitioner and Medical Clinic Fe |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $3.29since 2020-10-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $3.13since 2026-08-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Physicia |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $3.13since 2023-10-01 | — | — | Plans negotiate; applies out of network | — | Copy of PADL- Appendix A -Published Copy |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $3.10since 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) | $3.08since 2023-01-01 | — | — | Not classified | — | SCDHHS Infusion Center Fee Schedule (sch |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $3.01since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $1.00since 2026-08-25 | — | — | Not classified | — | Physician Drug Fee Schedule (REF-0130-Q) |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $1.00since 2026-01-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
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 J1738?
It depends on the state. Of the 14 states with a published fee-for-service rate, the median is $3.21. California pays the most ($7.59) and Kansas the least ($1.00).
Which state pays the highest Medicaid rate for J1738?
California, at $7.59, effective 2026-10-01.
Do managed-care plans pay the same rate for J1738?
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.