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Q5129 Medicaid reimbursement rates by state

Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg. 34 state Medicaid programs publish a fee-for-service rate for Q5129 at the physician psychologist level. Rates run from $20.44 in Colorado to $72.41 in Arizona, with a median of $23.65.

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

States publishing
34
Median rate
$23.65units vary by state
Highest
$72.41Arizona
Medicare (non-facility)
—not on the physician fee schedule

Q5129 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
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$72.41⚠ over 3× mediansince 2024-01-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Physicia
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$71.13since 2023-04-15unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$68.61since 2024-08-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$67.74since 2023-04-01——Plans negotiate; applies out of network—2026 Fee Schedule - Covered Procedures R
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$67.06since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$52.00since 2025-04-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$51.29since 2025-06-13——Not classified—Arkansas Medicaid Nurse Practitioner Fee
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$38.16since 2026-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$38.16since 2026-01-01——Not classified—Maryland Medicaid Professional Services
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$38.16since 2026-01-01——Not classified—CMAP fee schedule: Physician Office and
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$37.96since 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - HCPCS (i
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$34.65since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$34.65since 2026-08-25——Not classified—Physician Drug Fee Schedule (REF-0130-Q)
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$33.72since 2026-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$32.97since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$23.68since 2026-10-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$23.65since 2026-07-01——Not classified—Montana Healthcare Programs fee schedule
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$23.65since 2026-07-01——Plans negotiate; applies out of network—Medi-Cal Physician-Administered Drug Rat
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$23.65since 2026-07-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$23.65since 2026-08-01——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Physician Admi
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$23.65since 2026-07-01——Plans negotiate; applies out of network—MDHHS Practitioner and Medical Clinic Fe
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$23.65since 2026-07-01——State sets the plan rate—SoonerCare Title XIX Fee Schedule
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$23.64since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$23.20since 2026-07-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$23.20since 2026-07-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$22.24since 2026-07-01——Not classified—SCDHHS Infusion Center Fee Schedule (sch
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$22.24since 2026-09-01——Plans must pay at least this—Physician Administered Drug (PAD) Pricin
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$21.14since 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)$21.14since 2026-10-01——Plans negotiate; applies out of network—ODM provider-administered pharmaceutical
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$21.14since 2026-10-01——Plans negotiate; applies out of network—HCA Professional administered drugs fee
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$21.14since 2026-10-01——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$21.14since 2026-10-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$21.14since 2026-10-0110 MG—Plans negotiate; applies out of network—BMS Physician Administered Drug ASP Pric
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$20.44since 2026-10-01——Not classified—Q1/Q2/Q3/Q4 2026 PAD Fee Schedule

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 Q5129?

It depends on the state. Of the 34 states with a published fee-for-service rate, the median is $23.65. Arizona pays the most ($72.41) and Colorado the least ($20.44).

Which state pays the highest Medicaid rate for Q5129?

Arizona, at $72.41, effective 2024-01-01.

Do managed-care plans pay the same rate for Q5129?

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 Q5129 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
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