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J3392 Medicaid reimbursement rates by state

Injection, exagamglogene autotemcel, per treatment. 10 state Medicaid programs publish a fee-for-service rate for J3392 at the physician psychologist level. Rates run from $0.00 in California to $2,412,300.00 in Texas, with a median of $2,200,245.14.

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

States publishing
10
Median rate
$2,200,245.14units vary by state
Highest
$2,412,300.00Texas
Medicare (non-facility)
—not on the physician fee schedule

J3392 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
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$2,412,300.00since 2026-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$2,365,000.00since 2026-10-01——Plans negotiate; applies out of network—PADL Fee Schedule -Published Copy - Octo
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$2,365,000.00since 2026-10-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$2,332,000.00since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$2,200,490.28since 2025-01-01——Plans must pay at least this—Physician Administered Drug (PAD) Pricin
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$2,200,000.00since 2025-07-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$2,200,000.00since 2025-01-01——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)$2,046,413.60since 2026-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$1,980,000.00since 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)$0.00since 2025-01-01——Plans negotiate; applies out of network—Medi Cal Physician Administered Drug Rat

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 J3392?

It depends on the state. Of the 10 states with a published fee-for-service rate, the median is $2,200,245.14. Texas pays the most ($2,412,300.00) and California the least ($0.00).

Which state pays the highest Medicaid rate for J3392?

Texas, at $2,412,300.00, effective 2026-09-01.

Do managed-care plans pay the same rate for J3392?

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 J3392 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
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