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J3095 Medicaid reimbursement rates by state

Injection, telavancin, 10 mg. 27 state Medicaid programs publish a fee-for-service rate for J3095 at the physician psychologist level. Rates run from $1.84 in North Carolina to $9.42 in Indiana, with a median of $7.48.

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

States publishing
27
Median rate
$7.48units vary by state
Highest
$9.42Indiana
Medicare (non-facility)
—not on the physician fee schedule

J3095 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
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$9.42since 2026-04-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$8.37since 2024-03-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$8.15since 2026-10-01——Plans negotiate; applies out of network—ODM provider-administered pharmaceutical
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$8.15since 2026-10-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$8.15since 2026-10-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$7.88since 2026-10-01——Not classified—Q1/Q2/Q3/Q4 2026 PAD Fee Schedule
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$7.48since 2026-08-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$7.48since 2026-07-01——Plans negotiate; applies out of network—Medi-Cal Physician-Administered Drug Rat
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$7.48since 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)$7.48since 2026-07-01——Plans negotiate; applies out of network—MDHHS Practitioner and Medical Clinic Fe
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$7.48since 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)$7.48since 2026-07-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$7.48since 2026-07-01——Plans must pay at least this—Louisiana Medicaid Professional Services
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$7.48since 2026-07-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$7.48since 2026-07-01——State sets the plan rate—SoonerCare Title XIX Fee Schedule
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$7.48since 2026-09-01——Plans must pay at least this—Physician Administered Drug (PAD) Pricin
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$7.40since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$7.37since 2026-01-01——Not classified—CMAP fee schedule: Physician Office and
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$7.37since 2026-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$7.37since 2026-01-01——Not classified—Maryland Medicaid Professional Services
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$7.03since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$7.03since 2026-08-25——Not classified—Physician Drug Fee Schedule (REF-0130-Q)
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$6.94since 2023-01-01——Plans negotiate; applies out of network—SCDHHS Nurse Midwives Fee Schedule (sche
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$6.84since 2026-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
ArkansasPhysician or licensed psychologist (incl. BCBA-D) · Arkansas Medicaid (fee-for-service)$3.53since 2025-06-13——Not classified—Arkansas Medicaid Physician / CRNA / Fam
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$2.05since 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)$1.84since 2022-01-01——Plans must pay at least this—NC Medicaid fee schedule 'Nurse Midwives

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 J3095?

It depends on the state. Of the 27 states with a published fee-for-service rate, the median is $7.48. Indiana pays the most ($9.42 per unit) and North Carolina the least ($1.84).

Which state pays the highest Medicaid rate for J3095?

Indiana, at $9.42 per unit, effective 2026-04-01.

Do managed-care plans pay the same rate for J3095?

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

Track J3095 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
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