J2797 Medicaid reimbursement rates by state
Injection, rolapitant, 0.5 mg. 10 state Medicaid programs publish a fee-for-service rate for J2797. Rates run from $0.86 in Arizona to $5.35 in California, with a median of $0.89.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 10
- Median rate
- $0.89units vary by state
- Highest
- $5.35California
- Medicare (non-facility)
- —not on the physician fee schedule
J2797 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) | $5.35⚠ over 3× mediansince 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $1.58since 2025-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $0.96since 2022-01-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Nurse Practiti |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $0.95since 2019-01-01 | — | — | Plans negotiate; applies out of network | — | ODM provider-administered pharmaceutical |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $0.89since 2019-01-01 | — | — | Plans negotiate; applies out of network | — | PADL- Appendix A - Published Copy for 1- |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $0.89since 2021-01-01 | — | — | Plans negotiate; applies out of network | — | HCA Professional administered drugs fee |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $0.89since 2019-01-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $0.87since 2019-01-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule (Wayback capture 20250 |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $0.87since 2022-07-01 | — | — | Not classified | — | SCDHHS Infusion Center Fee Schedule (sch |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $0.86since 2024-04-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Physicia |
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 J2797?
It depends on the state. Of the 10 states with a published fee-for-service rate, the median is $0.89. California pays the most ($5.35) and Arizona the least ($0.86).
Which state pays the highest Medicaid rate for J2797?
California, at $5.35, effective 2026-10-01.
Do managed-care plans pay the same rate for J2797?
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.