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J3246 Medicaid reimbursement rates by state

Injection, tirofiban hcl, 0.25 mg. 15 state Medicaid programs publish a fee-for-service rate for J3246 at the physician psychologist level. Rates run from $2.53 in Colorado to $9.29 in New Jersey, with a median of $2.92.

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

States publishing
15
Median rate
$2.92units vary by state
Highest
$9.29New Jersey
Medicare (non-facility)
—not on the physician fee schedule

J3246 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)$9.29⚠ over 3× mediansince 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$4.10since 2023-07-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$3.45since 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)$3.45since 2026-01-01——Not classified—Maryland Medicaid Professional Services
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$3.45since 2026-01-01——Not classified—CMAP fee schedule: Physician Office and
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$2.92since 2026-07-01——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)$2.92since 2026-08-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$2.92since 2026-07-01——Plans negotiate; applies out of network—MDHHS Practitioner and Medical Clinic Fe
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$2.91since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$2.91since 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)$2.91since 2026-07-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$2.62since 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$2.62since 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)$2.62since 2026-10-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$2.53since 2026-10-01——Not classified—Q1/Q2/Q3/Q4 2026 PAD Fee Schedule

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 J3246?

It depends on the state. Of the 15 states with a published fee-for-service rate, the median is $2.92. New Jersey pays the most ($9.29) and Colorado the least ($2.53).

Which state pays the highest Medicaid rate for J3246?

New Jersey, at $9.29, effective 2025-01-01.

Do managed-care plans pay the same rate for J3246?

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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