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J2547 Medicaid reimbursement rates by state

Injection, peramivir, 1 mg. 18 state Medicaid programs publish a fee-for-service rate for J2547 at the physician psychologist level. Rates run from $1.47 in Illinois to $6.04 in California, with a median of $1.58.

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

States publishing
18
Median rate
$1.58units vary by state
Highest
$6.04California
Medicare (non-facility)
—not on the physician fee schedule

J2547 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)$6.04⚠ over 3× mediansince 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$1.81since 2025-06-04——Not classified—Arkansas Medicaid Certified Nurse-Midwif
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$1.71since 2022-01-01——Plans must pay at least this—NC Medicaid fee schedule 'Nurse Practiti
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$1.69since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$1.67since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$1.66since 2016-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$1.62since 2018-04-01——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)$1.58since 2026-08-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$1.58since 2021-01-01——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)$1.58since 2016-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule (Wayback capture 20250
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$1.58since 2016-01-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$1.58since 2018-07-01——Plans must pay at least this—Louisiana Medicaid Professional Services
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$1.58since 2024-01-01——State sets the plan rate—SoonerCare Title XIX Fee Schedule
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$1.58since 2021-04-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$1.57since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$1.56since 2023-01-01——Not classified—SCDHHS Infusion Center Fee Schedule (sch
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$1.56since 2024-04-01——Plans must pay at least this—Physician Administered Drug (PAD) Pricin
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$1.47since 2020-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective

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 J2547?

It depends on the state. Of the 18 states with a published fee-for-service rate, the median is $1.58. California pays the most ($6.04) and Illinois the least ($1.47).

Which state pays the highest Medicaid rate for J2547?

California, at $6.04, effective 2026-10-01.

Do managed-care plans pay the same rate for J2547?

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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