Q2042 Medicaid reimbursement rates by state
Tisagenlecleucel, up to 600 million car-positive viable t.... 17 state Medicaid programs publish a fee-for-service rate for Q2042 at the physician psychologist level. Rates run from $0.00 in Arkansas to $626,315.83 in West Virginia, with a median of $611,693.17.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 17
- Median rate
- $611,693.17units vary by state
- Highest
- $626,315.83West Virginia
- Medicare (non-facility)
- —not on the physician fee schedule
Q2042 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 |
|---|---|---|---|---|---|---|
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $626,315.83since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | BMS Physician Administered Drug ASP Pric |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $626,315.83since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | PADL Fee Schedule -Published Copy - Octo |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $626,315.83since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | ODM provider-administered pharmaceutical |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $626,315.83since 2026-10-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $611,693.17since 2026-07-01 | — | — | State sets the plan rate | — | SoonerCare Title XIX Fee Schedule |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $611,693.17since 2026-08-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Physicia |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $611,693.17since 2026-07-01 | — | — | 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) | $611,693.17since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $611,693.17since 2026-09-01 | — | — | Plans must pay at least this | — | Physician Administered Drug (PAD) Pricin |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $566,531.30since 2026-01-01 | — | — | Not classified | — | CMAP fee schedule: Physician Office and |
| MontanaPhysician or licensed psychologist (incl. BCBA-D) · Montana Medicaid and HMK Plus (fee-for-service) | $566,531.30since 2025-10-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $566,531.30since 2026-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $523,151.79since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $489,483.04since 2026-07-01 | — | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $87,384.74since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Physician-Administered Drug Rat |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $6,116.93since 2026-07-01 | — | — | Not classified | — | SCDHHS Infusion Center Fee Schedule (sch |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $0.00since 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 Q2042?
It depends on the state. Of the 17 states with a published fee-for-service rate, the median is $611,693.17. West Virginia pays the most ($626,315.83) and Arkansas the least ($0.00).
Which state pays the highest Medicaid rate for Q2042?
West Virginia, at $626,315.83, effective 2026-10-01.
Do managed-care plans pay the same rate for Q2042?
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.