Q0237 Medicaid reimbursement rates by state
Injection, tocilizumab-anoh. 12 state Medicaid programs publish a fee-for-service rate for Q0237 at the agency level. Rates run from $1.23 in Kansas to $20.07 in Utah, with a median of $4.92.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 12
- Median rate
- $4.92units vary by state
- Highest
- $20.07Utah
- Medicare (non-facility)
- —not on the physician fee schedule
Q0237 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.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| UtahAgency provider · Utah Medicaid (fee-for-service, Traditional plan) | $20.07⚠ over 3× mediansince 2026-04-01 | — | — | 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) | $4.92since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $4.92since 2026-04-01 | — | — | 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) | $4.92since 2026-04-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $4.92since 2026-04-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $4.92since 2026-06-01 | — | — | Plans must pay at least this | — | Physician Administered Drug (PAD) Pricin |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $4.92since 2026-04-01 | 1 MG | — | Plans negotiate; applies out of network | — | BMS Physician Administered Drug ASP Pric |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $4.92since 2026-04-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $4.92since 2026-04-01 | — | — | Not classified | — | South Dakota Medicaid Drugs and Biologic |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $4.43since 2026-08-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Physicia |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $4.27since 2026-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $1.23since 2026-04-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
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 Q0237?
It depends on the state. Of the 12 states with a published fee-for-service rate, the median is $4.92. Utah pays the most ($20.07) and Kansas the least ($1.23).
Which state pays the highest Medicaid rate for Q0237?
Utah, at $20.07, effective 2026-04-01.
Do managed-care plans pay the same rate for Q0237?
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.