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J9376 Medicaid reimbursement rates by state

Injection, pozelimab-bbfg, 1 mg. 15 state Medicaid programs publish a fee-for-service rate for J9376 at the physician psychologist level. Rates run from $77.89 in Arizona to $98.66 in Arkansas, with a median of $86.54.

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

States publishing
15
Median rate
$86.54units vary by state
Highest
$98.66Arkansas
Medicare (non-facility)
—not on the physician fee schedule

J9376 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
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$98.66since 2025-06-13——Not classified—Arkansas Medicaid Nurse Practitioner Fee
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$93.46since 2026-05-01——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Physician Admi
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$92.42since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$91.00since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$87.15since 2024-04-01——Not classified—SCDHHS Infusion Center Fee Schedule (sch
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$86.54since 2026-06-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$86.54since 2026-01-01——Not classified—Maryland Medicaid Professional Services
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$86.54since 2025-01-01——Plans must pay at least this—Louisiana Medicaid Professional Services
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$86.54since 2026-08-25——Not classified—Physician Drug Fee Schedule (REF-0130-Q)
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$86.54since 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$86.54since 2024-04-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$86.53since 2024-04-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$85.67since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$80.50since 2025-10-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$77.89since 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 J9376?

It depends on the state. Of the 15 states with a published fee-for-service rate, the median is $86.54. Arkansas pays the most ($98.66) and Arizona the least ($77.89).

Which state pays the highest Medicaid rate for J9376?

Arkansas, at $98.66, effective 2025-06-13.

Do managed-care plans pay the same rate for J9376?

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

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