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J7629 Medicaid reimbursement rates by state

Bitolterol mesylate, inhalation solution. 7 state Medicaid programs publish a fee-for-service rate for J7629 at the physician psychologist level. Rates run from $0.06 in Washington to $4.17 in New Mexico, with a median of $0.18.

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

States publishing
7
Median rate
$0.18units vary by state
Highest
$4.17New Mexico
Medicare (non-facility)
—not on the physician fee schedule

J7629 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
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$4.17⚠ over 3× mediansince 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$2.47⚠ over 3× mediansince 2026-07-01——Not classified—Health First Colorado Physician Fee Sche
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$0.18since 2005-04-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$0.18since 2013-07-01——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)$0.17since 2024-04-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$0.17since 2005-09-01——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$0.06since 2021-07-01——Plans negotiate; applies out of network—HCA Professional administered drugs fee

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 J7629?

It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $0.18. New Mexico pays the most ($4.17) and Washington the least ($0.06).

Which state pays the highest Medicaid rate for J7629?

New Mexico, at $4.17, effective 2025-01-01.

Do managed-care plans pay the same rate for J7629?

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

Track J7629 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
Medicaid rates by state