J7640 Medicaid reimbursement rates by state
Formoterol, inhalation solution, compounded product. 7 state Medicaid programs publish a fee-for-service rate for J7640 at the physician psychologist level. Rates run from $0.03 in Colorado to $5.91 in Ohio, with a median of $1.85.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 7
- Median rate
- $1.85units vary by state
- Highest
- $5.91Ohio
- Medicare (non-facility)
- —not on the physician fee schedule
J7640 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 |
|---|---|---|---|---|---|---|
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $5.91⚠ over 3× mediansince 2013-09-01 | — | — | Plans negotiate; applies out of network | — | ODM provider-administered pharmaceutical |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $3.25since 2025-07-01 | — | — | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $2.69since 2013-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $1.85since 2010-02-01 | — | — | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $1.84since 2007-01-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $1.69since 2023-01-01 | — | — | Not classified | — | MaineCare Section 90 - Drug Rates/Fee Sc |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $0.03since 2021-01-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
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 J7640?
It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $1.85. Ohio pays the most ($5.91) and Colorado the least ($0.03).
Which state pays the highest Medicaid rate for J7640?
Ohio, at $5.91, effective 2013-09-01.
Do managed-care plans pay the same rate for J7640?
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.