Q5156 Medicaid reimbursement rate by state (2026)
Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg. Medicaid pays a median of $4.60 for Q5156 across 27 states, from $3.10 in West Virginia to $12.41 in Maryland.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 27
- National median
- $4.60units vary by state
- Lowest
- $3.10West Virginia
- Highest
- $12.41Maryland
What does Medicaid pay for Q5156?
27 state Medicaid programs publish a fee-for-service rate for Q5156 at the physician psychologist level. The national median is $4.60 (units differ between states). Maryland pays the most, $12.41, and West Virginia the least, $3.10 per 1 MG, a 4.0x spread.
Q5156 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 27 states with every variant, modifier and effective date.
Frequently asked questions
What does Medicaid pay for Q5156?
It depends on the state. Of the 27 states with a published fee-for-service rate, the median is $4.60. Maryland pays the most ($12.41) and West Virginia the least ($3.10 per 1 MG).
Which state pays the highest Medicaid rate for Q5156?
Maryland, at $12.41, effective 2026-04-01.
Do managed-care plans pay the same rate for Q5156?
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 workspace shows the rule for each state, cited to the contract or statute.