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J9190 Medicaid reimbursement rates by state

Injection, fluorouracil, 500 mg. 30 state Medicaid programs publish a fee-for-service rate for J9190 at the physician psychologist level. Rates run from $1.62 in Arkansas to $5.81 in Iowa, with a median of $2.02.

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

States publishing
30
Median rate
$2.02units vary by state
Highest
$5.81Iowa
Medicare (non-facility)
—not on the physician fee schedule

J9190 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)$5.81since 2024-05-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$4.28since 2026-10-01——Plans negotiate; applies out of network—PADL Fee Schedule -Published Copy - Octo
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$3.28since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$2.93since 2026-07-01——Plans negotiate; applies out of network—2026 Fee Schedule - Covered Procedures R
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$2.74since 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)$2.23since 2025-04-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$2.10since 2026-09-01——Plans must pay at least this—Physician Administered Drug (PAD) Pricin
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$2.06since 2026-08-25——Not classified—Physician Drug Fee Schedule (REF-0130-Q)
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$2.06since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$2.02since 2026-08-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$2.02since 2026-07-01——Plans negotiate; applies out of network—Medi-Cal Physician-Administered Drug Rat
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$2.02since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$2.02since 2026-07-01——Plans negotiate; applies out of network—HCA Professional administered drugs fee
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$2.02since 2026-07-01——Plans negotiate; applies out of network—MDHHS Practitioner and Medical Clinic Fe
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$2.02since 2026-07-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$2.02since 2026-07-01——Plans must pay at least this—Louisiana Medicaid Professional Services
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$2.02since 2026-07-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$2.02since 2026-07-01——State sets the plan rate—SoonerCare Title XIX Fee Schedule
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$2.02since 2026-07-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$2.02since 2026-07-01——Not classified—MaineCare Section 90 - Drug Rates/Fee Sc
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$2.00since 2026-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$1.99since 2025-10-01——Plans negotiate; applies out of network—MHCP Fee Schedule (Wayback capture 20260
MontanaPhysician or licensed psychologist (incl. BCBA-D) · Montana Medicaid and HMK Plus (fee-for-service)$1.94since 2026-01-01——Not classified—Montana Healthcare Programs fee schedule
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$1.94since 2025-07-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$1.94since 2026-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$1.94since 2026-01-01——Not classified—Maryland Medicaid Professional Services
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$1.89since 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - HCPCS (i
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$1.78since 2022-01-01——Plans must pay at least this—NC Medicaid fee schedule 'Nurse Midwives
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$1.68since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$1.62since 2025-06-13——Not classified—Arkansas Medicaid Nurse Practitioner Fee

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 J9190?

It depends on the state. Of the 30 states with a published fee-for-service rate, the median is $2.02. Iowa pays the most ($5.81) and Arkansas the least ($1.62).

Which state pays the highest Medicaid rate for J9190?

Iowa, at $5.81, effective 2024-05-01.

Do managed-care plans pay the same rate for J9190?

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.

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