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J2312 Medicaid reimbursement rates by state

Injection, naloxone hydrochloride, not otherwise specified. 25 state Medicaid programs publish a fee-for-service rate for J2312 at the physician psychologist level. Rates run from $0.06 in Virginia to $4.53 in California, with a median of $0.07.

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

States publishing
25
Median rate
$0.07units vary by state
Highest
$4.53California
Medicare (non-facility)
—not on the physician fee schedule

J2312 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
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$4.53⚠ over 3× mediansince 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)$1.62⚠ over 3× mediansince 2026-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$0.23⚠ over 3× mediansince 2026-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$0.08since 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)$0.08since 2026-10-01——Plans negotiate; applies out of network—ODM provider-administered pharmaceutical
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$0.08since 2026-10-01——Plans negotiate; applies out of network—HCA Professional administered drugs fee
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$0.08since 2025-07-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$0.08since 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)$0.08since 2026-10-01——Plans must pay at least this—KMAP Fee Schedule TXIX Medicaid (FeeSche
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$0.07since 2026-08-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$0.07since 2026-08-01——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Physician Admi
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$0.07since 2025-07-01——Paid by the state, outside plans—MDHHS PIHP/CMHSP Physician Injectable Dr
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$0.07since 2026-07-01——Not classified—Q1/Q2/Q3/Q4 2026 PAD Fee Schedule
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$0.07since 2026-01-01——Not classified—Maryland Medicaid Professional Services
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$0.07since 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)$0.07since 2025-07-01——Not classified—CMAP fee schedule: Free-Standing Substan
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$0.07since 2026-01-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$0.07since 2025-09-05——Not classified—Arkansas Medicaid Nurse Practitioner Fee
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$0.07since 2025-07-01——State sets the plan rate—SoonerCare Title XIX Fee Schedule
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$0.07since 2025-07-01——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)$0.07since 2026-02-01——Plans must pay at least this—Physician Administered Drug (PAD) Pricin
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$0.06since 2025-07-01——Plans negotiate; applies out of network—Administrative Bulletin 25-28: 101 CMR 3
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$0.06since 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)$0.06since 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)$0.06since 2026-04-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv

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 J2312?

It depends on the state. Of the 25 states with a published fee-for-service rate, the median is $0.07. California pays the most ($4.53) and Virginia the least ($0.06).

Which state pays the highest Medicaid rate for J2312?

California, at $4.53, effective 2026-10-01.

Do managed-care plans pay the same rate for J2312?

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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