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J9600 Medicaid reimbursement rates by state

Injection, porfimer sodium, 75 mg. 12 state Medicaid programs publish a fee-for-service rate for J9600 at the physician psychologist level. Rates run from $2,444.76 in Arkansas to $25,188.84 in North Carolina, with a median of $11,455.49.

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

States publishing
12
Median rate
$11,455.49units vary by state
Highest
$25,188.84North Carolina
Medicare (non-facility)
—not on the physician fee schedule

J9600 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
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$25,188.84since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Local Health D
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$24,722.38since 2025-04-01——Plans negotiate; applies out of network—MDHHS Practitioner and Medical Clinic Fe
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$23,323.00since 2026-08-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$22,590.50since 2024-03-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$21,303.60since 2023-01-01——Not classified—SCDHHS Infusion Center Fee Schedule (sch
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$19,906.23since 2013-09-01——Plans negotiate; applies out of network—ODM provider-administered pharmaceutical
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$3,004.74since 2011-07-01——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)$3,004.74since 2011-07-01——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$3,004.74since 2011-07-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$2,934.28since 2026-01-01——Not classified—Maryland Medicaid Professional Services
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$2,637.93since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$2,444.76since 2025-06-13——Not classified—Arkansas Medicaid Nurse Practitioner Fee

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 J9600?

It depends on the state. Of the 12 states with a published fee-for-service rate, the median is $11,455.49. North Carolina pays the most ($25,188.84) and Arkansas the least ($2,444.76).

Which state pays the highest Medicaid rate for J9600?

North Carolina, at $25,188.84, effective 2025-10-01.

Do managed-care plans pay the same rate for J9600?

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 J9600 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
Medicaid rates by state