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Q0234 Medicaid reimbursement rates by state

Injection, tocilizumab-bavi. 9 state Medicaid programs publish a fee-for-service rate for Q0234 at the clinical nurse specialist level. Rates run from $5.69 in Arizona to $6.33 in Ohio, with a median of $6.33.

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

States publishing
9
Median rate
$6.33units vary by state
Highest
$6.33Ohio
Medicare (non-facility)
—not on the physician fee schedule

Q0234 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
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$6.33since 2026-07-01——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)$6.33since 2026-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$6.33since 2026-07-01——Not classified—Maryland Medicaid Professional Services
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$6.33since 2026-07-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid (KMAP fee-for-service schedule)$6.33since 2026-07-01——Plans must pay at least this—KMAP Fee Schedule TXIX Medicaid (FeeSche
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$6.33since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$6.32since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$6.12since 2026-07-01——Not classified—Q1/Q2/Q3/Q4 2026 PAD Fee Schedule
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$5.69since 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 Q0234?

It depends on the state. Of the 9 states with a published fee-for-service rate, the median is $6.33. Ohio pays the most ($6.33) and Arizona the least ($5.69).

Which state pays the highest Medicaid rate for Q0234?

Ohio, at $6.33, effective 2026-07-01.

Do managed-care plans pay the same rate for Q0234?

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 Q0234 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
Medicaid rates by state