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J1834 Medicaid reimbursement rates by state

Injection, isoniazid, 1 mg. 18 state Medicaid programs publish a fee-for-service rate for J1834 at the physician psychologist level. Rates run from $0.25 in Illinois to $6.72 in Wisconsin, with a median of $0.32.

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

States publishing
18
Median rate
$0.32units vary by state
Highest
$6.72Wisconsin
Medicare (non-facility)
—not on the physician fee schedule

J1834 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
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$6.72⚠ over 3× mediansince 2025-10-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$4.78⚠ over 3× mediansince 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$0.34since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$0.33since 2025-10-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$0.33since 2025-12-01——Not classified—Arkansas Medicaid Certified Nurse-Midwif
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$0.32since 2025-10-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$0.32since 2025-10-01——Plans negotiate; applies out of network—HCA Professional administered drugs fee
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$0.32since 2025-10-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$0.32since 2026-08-25——Not classified—Physician Drug Fee Schedule (REF-0130-Q)
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$0.32since 2025-10-01——State sets the plan rate—SoonerCare Title XIX Fee Schedule
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid (KMAP fee-for-service schedule)$0.32since 2025-10-01——Plans must pay at least this—KMAP Fee Schedule TXIX Medicaid (FeeSche
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$0.32since 2025-10-01——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)$0.31since 2026-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$0.30since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$0.30since 2025-10-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$0.29since 2026-08-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$0.29since 2026-02-01——Plans must pay at least this—Physician Administered Drug (PAD) Pricin
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$0.25since 2025-10-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective

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 J1834?

It depends on the state. Of the 18 states with a published fee-for-service rate, the median is $0.32. Wisconsin pays the most ($6.72) and Illinois the least ($0.25).

Which state pays the highest Medicaid rate for J1834?

Wisconsin, at $6.72, effective 2025-10-01.

Do managed-care plans pay the same rate for J1834?

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

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