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J2799 Medicaid reimbursement rates by state

Injection, risperidone (uzedy), 1 mg. 17 state Medicaid programs publish a fee-for-service rate for J2799 at the physician psychologist level. Rates run from $24.48 in Illinois to $29.62 in California, with a median of $26.18.

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

States publishing
17
Median rate
$26.18units vary by state
Highest
$29.62California
Medicare (non-facility)
—not on the physician fee schedule

J2799 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)$29.62since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$28.68since 2026-04-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$26.23since 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)$26.23since 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$26.23since 2026-10-01——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)$26.23since 2026-10-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$26.18since 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)$26.18since 2026-08-01——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Physician Admi
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$26.18since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$26.18since 2026-07-01——Paid by the state, outside plans—MDHHS PIHP/CMHSP Physician Injectable Dr
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$26.18since 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)$26.18since 2026-07-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$26.18since 2026-07-01——Plans negotiate; applies out of network—SCDHHS Nurse Midwives Fee Schedule (sche
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$25.37since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$25.36since 2026-10-01——Not classified—Q1/Q2/Q3/Q4 2026 PAD Fee Schedule
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$25.04since 2026-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$24.48since 2026-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective

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 J2799?

It depends on the state. Of the 17 states with a published fee-for-service rate, the median is $26.18. California pays the most ($29.62) and Illinois the least ($24.48).

Which state pays the highest Medicaid rate for J2799?

California, at $29.62, effective 2026-10-01.

Do managed-care plans pay the same rate for J2799?

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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