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J9262 Medicaid reimbursement rates by state

Injection, omacetaxine mepesuccinate, 0.01 mg. 26 state Medicaid programs publish a fee-for-service rate for J9262 at the physician psychologist level. Rates run from $2.36 in New Jersey to $238.57 in Arkansas, with a median of $3.95.

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

States publishing
26
Median rate
$3.95units vary by state
Highest
$238.57Arkansas
Medicare (non-facility)
—not on the physician fee schedule

J9262 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
ArkansasPhysician or licensed psychologist (incl. BCBA-D) · Arkansas Medicaid (fee-for-service)$238.57⚠ over 3× mediansince 2025-06-13——Not classified—Arkansas Medicaid Physician / CRNA / Fam
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$7.49since 2025-04-01——Not classified—MaineCare Section 90 - Drug Rates/Fee Sc
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$4.42since 2024-04-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$4.06since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$3.99since 2023-04-01unit—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)$3.96since 2024-09-01——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)$3.96since 2026-01-01——Not classified—Maryland Medicaid Professional Services
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$3.96since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$3.95since 2024-04-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$3.95since 2024-04-01——Plans negotiate; applies out of network—ODM provider-administered pharmaceutical
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$3.95since 2024-04-01——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)$3.95since 2024-04-01——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)$3.95since 2024-04-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$3.95since 2024-04-01——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$3.95since 2024-04-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$3.95since 2024-04-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$3.85since 2024-03-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$3.80since 2026-08-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$3.80since 2025-07-01——Plans negotiate; applies out of network—HCA Professional administered drugs fee
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$3.80since 2025-01-01——Plans must pay at least this—Louisiana Medicaid Professional Services
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$3.74since 2024-07-01——Plans negotiate; applies out of network—SCDHHS Nurse Midwives Fee Schedule (sche
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$3.74since 2025-01-01——Plans must pay at least this—Physician Administered Drug (PAD) Pricin
WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health)$3.65since 2022-10-01——Not classified—Wyoming Medicaid Downloadable Fee Schedu
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$3.42since 2025-09-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$2.46since 2022-01-01——Plans must pay at least this—NC Medicaid fee schedule 'Nurse Practiti
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$2.36since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS

Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 J9262?

It depends on the state. Of the 26 states with a published fee-for-service rate, the median is $3.95. Arkansas pays the most ($238.57) and New Jersey the least ($2.36).

Which state pays the highest Medicaid rate for J9262?

Arkansas, at $238.57, effective 2025-06-13.

Do managed-care plans pay the same rate for J9262?

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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