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J1952 Medicaid reimbursement rates by state

Leuprolide injectable, camcevi, 1 mg. 22 state Medicaid programs publish a fee-for-service rate for J1952 at the physician psychologist level. Rates run from $0.00 in Arkansas to $106.75 in Indiana, with a median of $42.05.

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

States publishing
22
Median rate
$42.05units vary by state
Highest
$106.75Indiana
Medicare (non-facility)
—not on the physician fee schedule

J1952 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
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$106.75since 2024-07-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$91.93since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$57.03since 2026-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$57.03since 2026-01-01——Not classified—Maryland Medicaid Professional Services
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$57.03since 2026-01-01——Not classified—CMAP fee schedule: Physician Office and
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$44.41since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$42.06since 2026-08-01——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Physician Admi
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$42.06since 2026-07-01——Not classified—SCDHHS Infusion Center Fee Schedule (sch
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$42.06since 2026-07-01——Plans negotiate; applies out of network—MDHHS Practitioner and Medical Clinic Fe
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$42.06since 2026-07-01——State sets the plan rate—SoonerCare Title XIX Fee Schedule
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$42.05since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$42.05since 2026-07-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$42.05since 2026-07-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$39.95since 2026-08-25——Not classified—Physician Drug Fee Schedule (REF-0130-Q)
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$38.87since 2026-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$37.85since 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)$36.37since 2026-10-01——Plans negotiate; applies out of network—PADL Fee Schedule -Published Copy - Octo
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$36.37since 2026-10-01——Plans negotiate; applies out of network—ODM provider-administered pharmaceutical
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$36.37since 2026-10-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$36.37since 2026-10-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$35.17since 2026-10-01——Not classified—Q1/Q2/Q3/Q4 2026 PAD Fee Schedule
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$0.00since 2025-06-13——Not classified—Arkansas Medicaid Nurse Practitioner Fee

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 J1952?

It depends on the state. Of the 22 states with a published fee-for-service rate, the median is $42.05. Indiana pays the most ($106.75 per unit) and Arkansas the least ($0.00).

Which state pays the highest Medicaid rate for J1952?

Indiana, at $106.75 per unit, effective 2024-07-01.

Do managed-care plans pay the same rate for J1952?

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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