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J8501 Medicaid reimbursement rates by state

Aprepitant, oral, 5 mg. 17 state Medicaid programs publish a fee-for-service rate for J8501 at the physician psychologist level. Rates run from $2.32 in Illinois to $11.13 in Iowa, with a median of $3.06.

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

States publishing
17
Median rate
$3.06units vary by state
Highest
$11.13Iowa
Medicare (non-facility)
—not on the physician fee schedule

J8501 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
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$11.13⚠ over 3× mediansince 2021-07-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$4.71since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$3.07since 2026-07-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$3.07since 2026-08-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$3.07since 2026-07-01——State sets the plan rate—SoonerCare Title XIX Fee Schedule
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$3.07since 2026-09-01——Plans must pay at least this—Physician Administered Drug (PAD) Pricin
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$3.06since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$3.06since 2026-07-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$3.06since 2026-07-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$2.89since 2026-03-01——Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$2.86since 2025-04-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$2.77since 2026-01-01——Not classified—Maryland Medicaid Professional Services
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$2.77since 2026-01-01——Not classified—CMAP fee schedule: Physician Office and
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$2.51since 2026-10-01——Plans negotiate; applies out of network—ODM provider-administered pharmaceutical
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$2.51since 2026-10-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$2.43since 2026-10-01——Not classified—Q1/Q2/Q3/Q4 2026 PAD Fee Schedule
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$2.32since 2026-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective

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 J8501?

It depends on the state. Of the 17 states with a published fee-for-service rate, the median is $3.06. Iowa pays the most ($11.13) and Illinois the least ($2.32).

Which state pays the highest Medicaid rate for J8501?

Iowa, at $11.13, effective 2021-07-01.

Do managed-care plans pay the same rate for J8501?

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

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