J2326 Medicaid reimbursement rates by state
Injection, nusinersen, 0.1 mg. 22 state Medicaid programs publish a fee-for-service rate for J2326 at the physician psychologist level. Rates run from $542.09 in Kansas to $1,333.45 in Maine, with a median of $1,224.10.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 22
- Median rate
- $1,224.10units vary by state
- Highest
- $1,333.45Maine
- Medicare (non-facility)
- —not on the physician fee schedule
J2326 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 |
|---|---|---|---|---|---|---|
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $1,333.45since 2026-07-01 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $1,328.12since 2026-04-01 | unit | — | Paid by the state, outside plans | — | IHCP Professional Fee Schedule (Last Upd |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $1,290.17since 2026-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $1,269.07since 2026-06-01 | — | — | Plans must pay at least this | — | Physician Administered Drug (PAD) Pricin |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $1,267.85since 2026-07-01 | — | — | State sets the plan rate | — | SoonerCare Title XIX Fee Schedule |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $1,264.88since 2026-08-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Physicia |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $1,264.88since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $1,264.88since 2026-04-01 | — | — | Plans negotiate; applies out of network | — | PADL Fee Schedule -Published Copy - Apri |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $1,264.88since 2026-04-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $1,264.88since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $1,254.67since 2025-04-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Practitioner and Medical Clinic Fe |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $1,193.52since 2025-07-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| ArkansasPhysician or licensed psychologist (incl. BCBA-D) · Arkansas Medicaid (fee-for-service) | $1,187.50since 2025-06-13 | — | — | Not classified | — | Arkansas Medicaid Physician / CRNA / Fam |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $1,163.88since 2024-03-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $1,114.58since 2018-05-01 | — | — | Plans negotiate; applies out of network | — | ODM provider-administered pharmaceutical |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $1,104.06since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $1,073.13since 2023-01-01 | — | — | Not classified | — | SCDHHS Infusion Center Fee Schedule (sch |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $1,031.25since 2025-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $1,011.51since 2022-10-01 | — | — | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $1,005.76since 2025-09-01 | — | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $585.46since 2026-08-01 | — | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Physician Admi |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $542.09since 2026-10-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
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 J2326?
It depends on the state. Of the 22 states with a published fee-for-service rate, the median is $1,224.10. Maine pays the most ($1,333.45) and Kansas the least ($542.09).
Which state pays the highest Medicaid rate for J2326?
Maine, at $1,333.45, effective 2026-07-01.
Do managed-care plans pay the same rate for J2326?
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.
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