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J7643 Medicaid reimbursement rates by state

Glycopyrrolate, inhalation solution, compounded product. 7 state Medicaid programs publish a fee-for-service rate for J7643. Rates run from $0.84 in Washington to $5.20 in Arizona, with a median of $1.19.

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

States publishing
7
Median rate
$1.19units vary by state
Highest
$5.20Arizona
Medicare (non-facility)
—not on the physician fee schedule

J7643 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
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$5.20⚠ over 3× mediansince 2024-01-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$3.00since 2022-07-01——Plans negotiate; applies out of network—2026 Fee Schedule - Covered Procedures R
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$1.19since 2006-01-01——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)$1.19since 2026-01-01——Not classified—Maryland Medicaid Professional Services
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$1.04since 2006-07-15——Plans negotiate; applies out of network—ODM provider-administered pharmaceutical
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$1.04since 2011-11-23——Not classified—MaineCare Fee Schedule (MaineCare UCR, H
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$0.84since 2026-07-01——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 J7643?

It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $1.19. Arizona pays the most ($5.20) and Washington the least ($0.84).

Which state pays the highest Medicaid rate for J7643?

Arizona, at $5.20, effective 2024-01-01.

Do managed-care plans pay the same rate for J7643?

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 J7643 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
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