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J7211 Medicaid reimbursement rates by state

Injection, factor viii, (antihemophilic factor. 23 state Medicaid programs publish a fee-for-service rate for J7211 at the physician psychologist level. Rates run from $1.33 in Washington to $2.13 in Iowa, with a median of $1.57.

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

States publishing
23
Median rate
$1.57units vary by state
Highest
$2.13Iowa
Medicare (non-facility)
—not on the physician fee schedule

J7211 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
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$2.13since 2024-03-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
ArkansasPhysician or licensed psychologist (incl. BCBA-D) · Arkansas Medicaid (fee-for-service)$1.99since 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)$1.72since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$1.60since 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)$1.60since 2026-07-01——Plans negotiate; applies out of network—MDHHS Practitioner and Medical Clinic Fe
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$1.60since 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)$1.60since 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)$1.60since 2026-09-01——Plans must pay at least this—Physician Administered Drug (PAD) Pricin
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$1.59since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$1.59since 2026-07-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$1.57since 2026-01-01——Not classified—CMAP fee schedule: Physician Office and
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$1.57since 2026-10-01——Plans negotiate; applies out of network—ODM provider-administered pharmaceutical
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$1.57since 2026-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$1.57since 2026-10-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$1.57since 2026-01-01——Not classified—Maryland Medicaid Professional Services
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$1.57since 2026-10-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$1.56since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$1.52since 2025-10-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$1.52since 2026-10-01——Not classified—Q1/Q2/Q3/Q4 2026 PAD Fee Schedule
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$1.50since 2025-06-01——Plans must pay at least this—NC Medicaid fee schedule 'Local Health D
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$1.48since 2024-10-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$1.46since 2025-10-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$1.33since 2026-10-01——Plans negotiate; applies out of network—HCA Professional administered drugs fee

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 J7211?

It depends on the state. Of the 23 states with a published fee-for-service rate, the median is $1.57. Iowa pays the most ($2.13) and Washington the least ($1.33).

Which state pays the highest Medicaid rate for J7211?

Iowa, at $2.13, effective 2024-03-01.

Do managed-care plans pay the same rate for J7211?

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.

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