J3398 Medicaid reimbursement rates by state
Injection, voretigene neparvovec-rzyl. 20 state Medicaid programs publish a fee-for-service rate for J3398 at the physician psychologist level. Rates run from $2,869.60 in Iowa to $456,875.00 in Oklahoma, with a median of $3,059.37.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 20
- Median rate
- $3,059.37units vary by state
- Highest
- $456,875.00Oklahoma
- Medicare (non-facility)
- —not on the physician fee schedule
J3398 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.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $456,875.00⚠ over 3× mediansince 2024-10-01 | — | — | State sets the plan rate | — | SoonerCare Title XIX Fee Schedule |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $456,875.00⚠ over 3× mediansince 2025-07-01 | — | — | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| District of ColumbiaAny qualified provider (rate does not vary by provider) · DC Medicaid (DHCF) fee-for-service | $425,000.00⚠ over 3× mediansince 2019-01-01 | — | — | Not classified | — | REFRP00178CSV - Medical Fee Schedule Rep |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $6,006.64since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $3,252.95since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| ArkansasPhysician or licensed psychologist (incl. BCBA-D) · Arkansas Medicaid (fee-for-service) | $3,230.00since 2025-06-13 | — | — | Not classified | — | Arkansas Medicaid Physician / CRNA / Fam |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $3,198.13since 2025-07-01 | unit | — | Paid by the state, outside plans | — | IHCP Professional Fee Schedule (Last Upd |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $3,106.75since 2025-03-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $3,070.09since 2026-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, Septembe |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $3,069.64since 2026-07-01 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $3,049.10since 2024-07-01 | — | — | Plans negotiate; applies out of network | — | SCDHHS Nurse Midwives Fee Schedule (sche |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $3,049.10since 2025-01-01 | — | — | Plans must pay at least this | — | Physician Administered Drug (PAD) Pricin |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $3,045.83since 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) | $3,045.83since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $3,045.83since 2024-10-01 | — | — | Plans negotiate; applies out of network | — | Provider's Administered Drug List - Exce |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $3,045.83since 2024-07-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule (Wayback capture 20250 |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $3,045.83since 2026-10-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $2,980.78since 2026-07-01 | — | — | Not classified | — | South Dakota Medicaid Drugs and Biologic |
| WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health) | $2,883.20since 2021-07-01 | — | — | Not classified | — | Wyoming Medicaid Downloadable Fee Schedu |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $2,869.60since 2024-03-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
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 J3398?
It depends on the state. Of the 20 states with a published fee-for-service rate, the median is $3,059.37. Oklahoma pays the most ($456,875.00) and Iowa the least ($2,869.60).
Which state pays the highest Medicaid rate for J3398?
Oklahoma, at $456,875.00, effective 2024-10-01.
Do managed-care plans pay the same rate for J3398?
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
90714Vaccines and immune globulins · 47 states90740Vaccines and immune globulins · 46 states90656Vaccines and immune globulins · 45 states90658Vaccines and immune globulins · 45 states90651Vaccines and immune globulins · 44 states90653Physician-administered drugs (J-codes) · 44 states90662Physician-administered drugs (J-codes) · 44 states90747Physician-administered drugs (J-codes) · 44 states90673Physician-administered drugs (J-codes) · 43 states90620Vaccines and immune globulins · 42 states90621Vaccines and immune globulins · 42 statesQ0112All potassium hydroxide (koh) preparations · 42 states
Track J3398 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.