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J9259 Medicaid reimbursement rates by state

Injection, paclitaxel protein-bound particles. 5 state Medicaid programs publish a fee-for-service rate for J9259. Rates run from $15.40 in Michigan to $16.39 in California, with a median of $15.45.

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

States publishing
5
Median rate
$15.45units vary by state
Highest
$16.39California
Medicare (non-facility)
—not on the physician fee schedule

J9259 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
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$16.39since 2024-10-01——Plans negotiate; applies out of network—Medi Cal Physician Administered Drug Rat
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$15.45since 2024-01-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$15.45since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$15.40since 2024-07-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$15.40since 2024-07-01——Plans negotiate; applies out of network—MDHHS Practitioner and Medical Clinic Fe

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 J9259?

It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $15.45. California pays the most ($16.39) and Michigan the least ($15.40).

Which state pays the highest Medicaid rate for J9259?

California, at $16.39, effective 2024-10-01.

Do managed-care plans pay the same rate for J9259?

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 J9259 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
Medicaid rates by state