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J7355 Medicaid reimbursement rates by state

Injection, travoprost, intracameral implant, 1 microgram. 34 state Medicaid programs publish a fee-for-service rate for J7355 at the physician psychologist level. Rates run from $169.54 in Idaho to $212.04 in Arkansas, with a median of $196.75.

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

States publishing
34
Median rate
$196.75units vary by state
Highest
$212.04Arkansas
Medicare (non-facility)
—not on the physician fee schedule

J7355 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
ArkansasPhysician or licensed psychologist (incl. BCBA-D) · Arkansas Medicaid (fee-for-service)$212.04since 2025-06-13——Not classified—Arkansas Medicaid Physician / CRNA / Fam
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$196.88since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$196.80since 2026-10-011 MCG—Plans negotiate; applies out of network—BMS Physician Administered Drug ASP Pric
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$196.80since 2026-10-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$196.80since 2026-10-01——Plans negotiate; applies out of network—PADL Fee Schedule -Published Copy - Octo
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$196.80since 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$196.80since 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)$196.80since 2026-10-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$196.80since 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)$196.80since 2026-10-01——Not classified—South Dakota Medicaid Drugs and Biologic
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$196.75since 2026-07-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$196.75since 2026-07-01——Plans negotiate; applies out of network—Medi-Cal Physician-Administered Drug Rat
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$196.75since 2026-08-01——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Physician Admi
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$196.75since 2026-07-01——Plans negotiate; applies out of network—MDHHS Practitioner and Medical Clinic Fe
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$196.75since 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)$196.75since 2026-09-01——Plans must pay at least this—Physician Administered Drug (PAD) Pricin
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$196.75since 2026-07-01——Not classified—MaineCare Fee Schedule (MaineCare UCR, H
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$196.74since 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)$196.74since 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)$196.74since 2026-07-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
MontanaPhysician or licensed psychologist (incl. BCBA-D) · Montana Medicaid and HMK Plus (fee-for-service)$196.23since 2026-01-01——Not classified—Montana Healthcare Programs fee schedule
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$196.23since 2026-01-01——Not classified—CMAP fee schedule: Physician Office and
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$196.23since 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)$196.23since 2026-01-01——Not classified—Maryland Medicaid Professional Services
District of ColumbiaAny qualified provider (rate does not vary by provider) · DC Medicaid (DHCF) fee-for-service$196.23since 2026-04-01——Not classified—REFRP00178CSV - Medical Fee Schedule Rep
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$195.30since 2024-07-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$191.58since 2024-07-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$191.56since 2026-04-01——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)$190.31since 2026-10-01——Not classified—Q1/Q2/Q3/Q4 2026 PAD Fee Schedule
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$186.00since 2024-07-01——Plans negotiate; applies out of network—2026 Fee Schedule - Covered Procedures R
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$185.93since 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - HCPCS (i
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$184.14since 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)$177.08since 2026-08-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$169.54since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju

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 J7355?

It depends on the state. Of the 34 states with a published fee-for-service rate, the median is $196.75. Arkansas pays the most ($212.04) and Idaho the least ($169.54).

Which state pays the highest Medicaid rate for J7355?

Arkansas, at $212.04, effective 2025-06-13.

Do managed-care plans pay the same rate for J7355?

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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