J9186 Medicaid reimbursement rates by state
Injection, etoposide (avyxa), 1 mg. 8 state Medicaid programs publish a fee-for-service rate for J9186. Rates run from $4.00 in California to $4.24 in Utah, with a median of $4.24.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 8
- Median rate
- $4.24units vary by state
- Highest
- $4.24Utah
- Medicare (non-facility)
- —not on the physician fee schedule
J9186 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 |
|---|---|---|---|---|---|---|
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $4.24since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $4.24since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | ODM provider-administered pharmaceutical |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $4.24since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | HCA Professional administered drugs fee |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $4.24since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $4.24since 2026-10-01 | — | — | Not classified | — | CMAP fee schedule: Physician Office and |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $4.24since 2026-10-01 | 1 MG | — | Plans negotiate; applies out of network | — | BMS Physician Administered Drug ASP Pric |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $4.24since 2026-10-01 | — | — | Not classified | — | South Dakota Medicaid Drugs and Biologic |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $4.00since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
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 J9186?
It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $4.24. Utah pays the most ($4.24) and California the least ($4.00).
Which state pays the highest Medicaid rate for J9186?
Utah, at $4.24, effective 2026-10-01.
Do managed-care plans pay the same rate for J9186?
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.