J7649 Medicaid reimbursement rates by state
Isoetharine hcl, inhalation solution. 8 state Medicaid programs publish a fee-for-service rate for J7649. Rates run from $0.14 in Virginia 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
- 8
- Median rate
- $0.18units vary by state
- Highest
- $4.17New Mexico
- Medicare (non-facility)
- —not on the physician fee schedule
J7649 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 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) | $3.34⚠ over 3× mediansince 2026-07-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $1.83⚠ over 3× mediansince 2001-05-24 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $0.20since 2001-09-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $0.16since 2011-11-23 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $0.14since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Physicia |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $0.14since 2021-01-01 | — | — | Plans negotiate; applies out of network | — | HCA Professional administered drugs fee |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $0.14since 2005-07-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
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 J7649?
It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $0.18. New Mexico pays the most ($4.17) and Virginia the least ($0.14).
Which state pays the highest Medicaid rate for J7649?
New Mexico, at $4.17, effective 2025-01-01.
Do managed-care plans pay the same rate for J7649?
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.