J9219 Medicaid reimbursement rates by state
Leuprolide acetate implant, 65 mg. 17 state Medicaid programs publish a fee-for-service rate for J9219 at the physician psychologist level. Rates run from $168.48 in Maine to $5,399.80 in Arkansas, with a median of $4,819.82.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 17
- Median rate
- $4,819.82units vary by state
- Highest
- $5,399.80Arkansas
- Medicare (non-facility)
- —not on the physician fee schedule
J9219 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 |
|---|---|---|---|---|---|---|
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $5,399.80since 2025-06-13 | — | — | Not classified | — | Arkansas Medicaid Nurse Practitioner Fee |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $5,115.60since 2020-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Physician fee schedule (2020 |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $5,108.99since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $4,973.50since 2025-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $4,819.82since 2025-07-01 | — | — | Plans negotiate; applies out of network | — | ODM provider-administered pharmaceutical |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $4,819.82since 2009-01-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $4,819.82since 2009-01-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $4,819.82since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $4,819.82since 2013-04-01 | — | — | 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 | $4,819.82since 2009-07-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $4,774.56since 2021-01-01 | — | — | Plans negotiate; applies out of network | — | HCA Professional administered drugs fee |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $4,578.83since 2024-04-01 | — | — | 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) | $4,528.81since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $4,164.33since 2025-09-01 | — | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $2,222.92since 2013-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $1,534.89since 2022-01-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Local Health D |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $168.48since 2016-04-01 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
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 J9219?
It depends on the state. Of the 17 states with a published fee-for-service rate, the median is $4,819.82. Arkansas pays the most ($5,399.80) and Maine the least ($168.48).
Which state pays the highest Medicaid rate for J9219?
Arkansas, at $5,399.80, effective 2025-06-13.
Do managed-care plans pay the same rate for J9219?
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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Track J9219 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.