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J2291 Medicaid reimbursement rates by state

Injection, nafcillin sodium (baxter), 20 mg. 22 state Medicaid programs publish a fee-for-service rate for J2291 at the physician psychologist level. Rates run from $0.13 in Colorado to $0.26 in Indiana, with a median of $0.15.

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

States publishing
22
Median rate
$0.15units vary by state
Highest
$0.26Indiana
Medicare (non-facility)
—not on the physician fee schedule

J2291 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)$0.26since 2025-10-01unit—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)$0.24since 2026-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$0.15since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$0.15since 2025-10-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$0.15since 2025-10-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$0.15since 2025-10-01——Plans negotiate; applies out of network—MDHHS Certified Nurse Midwife Fee Schedu
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$0.15since 2026-01-01——Not classified—Maryland Medicaid Professional Services
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$0.15since 2025-11-01——Plans must pay at least this—Louisiana Medicaid Professional Services
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$0.15since 2026-08-25——Not classified—Physician Drug Fee Schedule (REF-0130-Q)
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$0.15since 2025-10-01——Not classified—CMAP fee schedule: Physician Office and
ArkansasPhysician or licensed psychologist (incl. BCBA-D) · Arkansas Medicaid (fee-for-service)$0.15since 2025-12-01——Not classified—Arkansas Medicaid Physician / CRNA / Fam
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$0.15since 2025-10-01——State sets the plan rate—SoonerCare Title XIX Fee Schedule
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$0.15since 2025-10-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$0.15since 2026-02-01——Plans must pay at least this—Physician Administered Drug (PAD) Pricin
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$0.14since 2026-08-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$0.14since 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)$0.14since 2026-10-01——Plans negotiate; applies out of network—ODM provider-administered pharmaceutical
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$0.14since 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)$0.14since 2026-07-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$0.14since 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 (KMAP fee-for-service schedule)$0.14since 2026-10-01——Plans must pay at least this—KMAP Fee Schedule TXIX Medicaid (FeeSche
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$0.13since 2026-10-01——Not classified—Q1/Q2/Q3/Q4 2026 PAD Fee Schedule

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 J2291?

It depends on the state. Of the 22 states with a published fee-for-service rate, the median is $0.15. Indiana pays the most ($0.26 per unit) and Colorado the least ($0.13).

Which state pays the highest Medicaid rate for J2291?

Indiana, at $0.26 per unit, effective 2025-10-01.

Do managed-care plans pay the same rate for J2291?

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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