J7196 Medicaid reimbursement rates by state
Injection, antithrombin recombinant, 50 i.u.. 16 state Medicaid programs publish a fee-for-service rate for J7196 at the physician psychologist level. Rates run from $0.00 in Arkansas to $159.30 in Kansas, with a median of $101.43.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 16
- Median rate
- $101.43units vary by state
- Highest
- $159.30Kansas
- Medicare (non-facility)
- —not on the physician fee schedule
J7196 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 |
|---|---|---|---|---|---|---|
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $159.30since 2011-01-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $150.05since 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) | $142.30since 2021-10-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $140.50since 2026-08-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Physicia |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $140.50since 2024-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, June 202 |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $138.25since 2024-04-01 | — | — | Plans must pay at least this | — | Physician Administered Drug (PAD) Pricin |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $103.35since 2023-01-01 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $102.37since 2011-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $100.48since 2022-01-01 | — | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Physician Admi |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $100.06since 2026-07-01 | — | — | Not classified | — | South Dakota Medicaid Drugs and Biologic |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $97.50since 2011-09-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule (Wayback capture 20250 |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $2.81since 2024-09-01 | — | — | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $1.47since 2015-07-01 | — | — | 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) | $0.09since 2013-09-01 | — | — | Plans negotiate; applies out of network | — | ODM provider-administered pharmaceutical |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $0.06since 2025-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| ArkansasPhysician or licensed psychologist (incl. BCBA-D) · Arkansas Medicaid (fee-for-service) | $0.00since 2025-06-13 | — | — | Not classified | — | Arkansas Medicaid Physician / CRNA / Fam |
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 J7196?
It depends on the state. Of the 16 states with a published fee-for-service rate, the median is $101.43. Kansas pays the most ($159.30) and Arkansas the least ($0.00).
Which state pays the highest Medicaid rate for J7196?
Kansas, at $159.30, effective 2011-01-01.
Do managed-care plans pay the same rate for J7196?
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.