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Billing code J2860 · Pharmacy

J2860 Medicaid reimbursement rate by state (2026)

Injection, siltuximab, 10 mg. Medicaid pays a median of $173.30 for J2860 across 36 states, from $9.27 in North Carolina to $199.84 in Utah.

Data as of Oct 5, 202636 statesEvery rate links to its official source

States publishing
36
National median
$173.30units vary by state
Lowest
$9.27North Carolina
Highest
$199.84Utah
Answer

What does Medicaid pay for J2860?

36 state Medicaid programs publish a fee-for-service rate for J2860. The national median is $173.30 (units differ between states). Utah pays the most, $199.84, and North Carolina the least, $9.27, a 21.6x spread.

State ranking

J2860 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 36 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Utah Source · since 2026-10-01$199.84——Plans negotiate; applies out of network—
2Ohio Source · since 2026-10-01$178.43——Plans negotiate; applies out of network—
3Washington Source · since 2026-10-01$178.43——Plans negotiate; applies out of network—
18Virginia Source · since 2026-07-01$174.06——Plans negotiate; applies out of network—
19Colorado Source · since 2026-10-01$172.54——Not classified—
20South Carolina Source · since 2026-07-01$170.42——Not classified—
35Minnesota Source · since 2016-01-01$82.96——Plans negotiate; applies out of network—
36North Carolina Source · since 2022-01-01$9.27——Plans must pay at least this—
See all 36 states for J2860 — start free

28 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

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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; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track J2860 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
FAQ

Frequently asked questions

What does Medicaid pay for J2860?

It depends on the state. Of the 36 states with a published fee-for-service rate, the median is $173.30. Utah pays the most ($199.84) and North Carolina the least ($9.27).

Which state pays the highest Medicaid rate for J2860?

Utah, at $199.84, effective 2026-10-01.

Do managed-care plans pay the same rate for J2860?

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 workspace shows the rule for each state, cited to the contract or statute.