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Billing code J7356 · Pharmacy

J7356 Medicaid reimbursement rate by state (2026)

Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg. Medicaid pays a median of $0.70 for J7356 across 29 states, from $0.60 in Idaho to $0.78 in Arkansas.

Data as of Oct 5, 202629 statesEvery rate links to its official source

States publishing
29
National median
$0.70units vary by state
Lowest
$0.60Idaho
Highest
$0.78Arkansas
Answer

What does Medicaid pay for J7356?

29 state Medicaid programs publish a fee-for-service rate for J7356. The national median is $0.70 (units differ between states). Arkansas pays the most, $0.78, and Idaho the least, $0.60, a 1.3x spread.

State ranking

J7356 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 29 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Arkansas Source · since 2025-09-05$0.78——Not classified—
2Texas Source · since 2025-07-01$0.73——Plans negotiate; applies out of network—
3Indiana Source · since 2025-07-01$0.72unit—Plans must pay at least this—
14Wisconsin Source · since 2026-01-01$0.70——Plans negotiate; applies out of network—
15Maryland Source · since 2026-01-01$0.70——Not classified—
16Alabama Source · since 2026-08-25$0.70——Not classified—
28Vermont Source · since 2026-01-01$0.67——Not classified—
29Idaho Source · since 2026-07-01$0.60——Not classified—
See all 29 states for J7356 — start free

21 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

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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; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track J7356 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
FAQ

Frequently asked questions

What does Medicaid pay for J7356?

It depends on the state. Of the 29 states with a published fee-for-service rate, the median is $0.70. Arkansas pays the most ($0.78) and Idaho the least ($0.60).

Which state pays the highest Medicaid rate for J7356?

Arkansas, at $0.78, effective 2025-09-05.

Do managed-care plans pay the same rate for J7356?

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 workspace shows the rule for each state, cited to the contract or statute.