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J9247 Medicaid reimbursement rates by state

Injection, melphalan flufenamide, 1mg. 6 state Medicaid programs publish a fee-for-service rate for J9247 at the physician psychologist level. Rates run from $460.28 in Arizona to $509.85 in New Mexico, with a median of $492.29.

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

States publishing
6
Median rate
$492.29units vary by state
Highest
$509.85New Mexico
Medicare (non-facility)
—not on the physician fee schedule

J9247 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
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$509.85since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$503.50since 2023-01-01——Plans negotiate; applies out of network—Medi Cal Physician Administered Drug Rat
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$503.50since 2023-01-01——Plans negotiate; applies out of network—MDHHS Practitioner and Medical Clinic Fe
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$481.08since 2021-10-01——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)$470.25since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$460.28since 2024-04-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia

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 J9247?

It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $492.29. New Mexico pays the most ($509.85) and Arizona the least ($460.28).

Which state pays the highest Medicaid rate for J9247?

New Mexico, at $509.85, effective 2025-01-01.

Do managed-care plans pay the same rate for J9247?

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

Track J9247 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
Medicaid rates by state