J2796 Medicaid reimbursement rates by state
Injection, romiplostim, 10 micrograms. 5 state Medicaid programs publish a fee-for-service rate for J2796. Rates run from $41.61 in North Carolina to $101.05 in California, with a median of $101.05.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 5
- Median rate
- $101.05units vary by state
- Highest
- $101.05California
- Medicare (non-facility)
- —not on the physician fee schedule
J2796 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 |
|---|---|---|---|---|---|---|
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $101.05since 2024-10-01 | — | — | Plans negotiate; applies out of network | — | Medi Cal Physician Administered Drug Rat |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $101.05since 2024-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Physicia |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $101.05since 2024-10-01 | — | — | Plans negotiate; applies out of network | — | Provider's Administered Drug List - Exce |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $101.05since 2024-10-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Practitioner and Medical Clinic Fe |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $41.61since 2022-01-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Nurse Practiti |
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 J2796?
It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $101.05. California pays the most ($101.05) and North Carolina the least ($41.61).
Which state pays the highest Medicaid rate for J2796?
California, at $101.05, effective 2024-10-01.
Do managed-care plans pay the same rate for J2796?
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.