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J1890 Medicaid reimbursement rates by state

Injection, cephalothin sodium, up to 1 gram. 5 state Medicaid programs publish a fee-for-service rate for J1890 at the physician psychologist level. Rates run from $6.27 in New Mexico to $15.29 in Colorado, with a median of $9.45.

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

States publishing
5
Median rate
$9.45units vary by state
Highest
$15.29Colorado
Medicare (non-facility)
—not on the physician fee schedule

J1890 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
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$15.29since 2024-07-01——Not classified—Health First Colorado Physician Fee Sche
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$10.34since 2013-07-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$9.45since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$6.77since 2024-04-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$6.27since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC

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 J1890?

It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $9.45. Colorado pays the most ($15.29) and New Mexico the least ($6.27).

Which state pays the highest Medicaid rate for J1890?

Colorado, at $15.29, effective 2024-07-01.

Do managed-care plans pay the same rate for J1890?

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 J1890 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
Medicaid rates by state