J2212 Medicaid reimbursement rates by state
Injection, methylnaltrexone, 0.1 mg. 17 state Medicaid programs publish a fee-for-service rate for J2212 at the physician psychologist level. Rates run from $0.53 in Ohio to $4.47 in New Jersey, with a median of $1.56.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 17
- Median rate
- $1.56units vary by state
- Highest
- $4.47New Jersey
- Medicare (non-facility)
- —not on the physician fee schedule
J2212 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 |
|---|---|---|---|---|---|---|
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $4.47since 2025-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $1.75since 2026-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, Septembe |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $1.68since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | SCDHHS Nurse Midwives Fee Schedule (sche |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $1.68since 2026-09-01 | — | — | Plans must pay at least this | — | Physician Administered Drug (PAD) Pricin |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $1.67since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $1.67since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $1.59since 2026-09-01 | — | — | 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) | $1.56since 2026-08-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Physicia |
| AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $1.56since 2026-08-25 | — | — | Not classified | — | Physician Drug Fee Schedule (REF-0130-Q) |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $1.56since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $1.49since 2025-04-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $1.42since 2025-04-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $1.35since 2025-07-01 | — | — | 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) | $1.34since 2024-07-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule (Wayback capture 20250 |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $1.30since 2024-03-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $0.94since 2024-10-01 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $0.53since 2013-09-01 | — | — | Plans negotiate; applies out of network | — | ODM provider-administered pharmaceutical |
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 J2212?
It depends on the state. Of the 17 states with a published fee-for-service rate, the median is $1.56. New Jersey pays the most ($4.47) and Ohio the least ($0.53).
Which state pays the highest Medicaid rate for J2212?
New Jersey, at $4.47, effective 2025-01-01.
Do managed-care plans pay the same rate for J2212?
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
90656Vaccines and immune globulins · 40 states90658Vaccines and immune globulins · 40 states90714Vaccines and immune globulins · 40 states90653Physician-administered drugs (J-codes) · 39 states90662Physician-administered drugs (J-codes) · 39 states90673Physician-administered drugs (J-codes) · 39 states90651Vaccines and immune globulins · 38 states90740Vaccines and immune globulins · 38 statesQ4101Apligraf, per square centimeter (add-on · 37 statesJ0882Injection, darbepoetin alfa, 1 microgram · 37 statesJ0885Injection, epoetin alfa, (for non-esrd use), 1000 units · 37 statesJ1756Injection, iron sucrose, 1 mg · 37 states
Track J2212 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.