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J3030 Medicaid reimbursement rates by state

Injection, sumatriptan succinate, 6 mg. 33 state Medicaid programs publish a fee-for-service rate for J3030 at the physician psychologist level. Rates run from $5.34 in Utah to $137.25 in New Jersey, with a median of $50.00.

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

States publishing
33
Median rate
$50.00units vary by state
Highest
$137.25New Jersey
Medicare (non-facility)
—not on the physician fee schedule

J3030 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
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$137.25since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$121.11since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$86.24since 2026-09-01——Plans must pay at least this—Physician Administered Drug (PAD) Pricin
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$78.46since 2026-03-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$74.49since 2021-01-01——Plans negotiate; applies out of network—SCDHHS Podiatry Fee Schedule (schedule c
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$67.55since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$63.55since 2024-03-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$55.00since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$54.86since 2025-07-01——Not classified—Montana Healthcare Programs fee schedule
South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services)$54.73since 2026-07-01——Not classified—South Dakota Medicaid Drugs and Biologic
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$51.89since 2012-10-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$51.89since 2023-01-01——Plans negotiate; applies out of network—MDHHS Child and Adolescent Health Center
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$51.89since 2012-10-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$51.89since 2012-10-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$51.89since 2012-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$51.89since 2023-01-01——Not classified—MaineCare Section 90 - Drug Rates/Fee Sc
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$50.00since 2026-08-01——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)$50.00since 2026-10-01——Plans negotiate; applies out of network—PADL Fee Schedule -Published Copy - Octo
WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health)$47.73since 2021-01-01——Not classified—Wyoming Medicaid Downloadable Fee Schedu
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$46.68since 2026-01-01——Not classified—Maryland Medicaid Professional Services
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$40.44since 2025-09-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$37.00since 2026-10-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$30.02since 2025-06-13——Not classified—Arkansas Medicaid Nurse Practitioner Fee
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$30.01since 2026-06-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$24.25since 2013-09-01——Plans negotiate; applies out of network—ODM provider-administered pharmaceutical
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$12.00since 2026-08-25——Not classified—Physician Drug Fee Schedule (REF-0130-Q)
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$12.00since 2025-07-01——Plans negotiate; applies out of network—2026 Fee Schedule - Covered Procedures R
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$9.72since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Local Health D
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$9.45since 2025-04-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$7.50since 2026-07-01——Plans negotiate; applies out of network—HCA Professional administered drugs fee
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$7.39since 2025-10-01——State sets the plan rate—SoonerCare Title XIX Fee Schedule
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$6.33since 2023-10-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$5.34since 2026-04-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement

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 J3030?

It depends on the state. Of the 33 states with a published fee-for-service rate, the median is $50.00. New Jersey pays the most ($137.25) and Utah the least ($5.34).

Which state pays the highest Medicaid rate for J3030?

New Jersey, at $137.25, effective 2025-01-01.

Do managed-care plans pay the same rate for J3030?

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.

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