J7638 Medicaid reimbursement rates by state
Dexamethasone, inhalation solution, compounded product. 9 state Medicaid programs publish a fee-for-service rate for J7638 at the physician psychologist level. Rates run from $0.09 in Arizona to $0.20 in New Jersey, with a median of $0.12.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 9
- Median rate
- $0.12units vary by state
- Highest
- $0.20New Jersey
- Medicare (non-facility)
- —not on the physician fee schedule
J7638 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 |
|---|---|---|---|---|---|---|
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $0.20since 2025-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $0.19since 2002-04-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $0.13since 2011-11-23 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $0.12since 2006-04-01 | — | — | Plans negotiate; applies out of network | — | ODM provider-administered pharmaceutical |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $0.12since 2005-07-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $0.12since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $0.12since 2013-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $0.10since 2025-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Professional administered drugs fee |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $0.09since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Physicia |
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 J7638?
It depends on the state. Of the 9 states with a published fee-for-service rate, the median is $0.12. New Jersey pays the most ($0.20) and Arizona the least ($0.09).
Which state pays the highest Medicaid rate for J7638?
New Jersey, at $0.20, effective 2025-01-01.
Do managed-care plans pay the same rate for J7638?
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.