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J9248 Medicaid reimbursement rates by state

Injection, melphalan (hepzato), 1 mg. 15 state Medicaid programs publish a fee-for-service rate for J9248 at the physician psychologist level. Rates run from $721.33 in Arizona to $801.48 in Texas, with a median of $797.42.

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

States publishing
15
Median rate
$797.42units vary by state
Highest
$801.48Texas
Medicare (non-facility)
—not on the physician fee schedule

J9248 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
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$801.48since 2026-04-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$801.48since 2026-07-01——Plans negotiate; applies out of network—MDHHS Practitioner and Medical Clinic Fe
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$801.48since 2026-07-01——State sets the plan rate—SoonerCare Title XIX Fee Schedule
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$801.47since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$801.47since 2026-07-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$797.42since 2026-10-01——Plans negotiate; applies out of network—PADL Fee Schedule -Published Copy - Octo
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$797.42since 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)$797.42since 2026-10-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$797.42since 2026-10-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$795.00since 2026-01-01——Not classified—CMAP fee schedule: Physician Office and
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$795.00since 2026-01-01——Not classified—Maryland Medicaid Professional Services
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$795.00since 2026-08-25——Not classified—Physician Drug Fee Schedule (REF-0130-Q)
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$773.53since 2025-10-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$722.70since 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)$721.33since 2026-08-01——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 J9248?

It depends on the state. Of the 15 states with a published fee-for-service rate, the median is $797.42. Texas pays the most ($801.48) and Arizona the least ($721.33).

Which state pays the highest Medicaid rate for J9248?

Texas, at $801.48, effective 2026-04-01.

Do managed-care plans pay the same rate for J9248?

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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