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Q5169 Medicaid reimbursement rate by state (2026)

Injection, pegfilgrastim-unne (armlupeg), biosimilar, 0.5 mg. Medicaid pays a median of $519.48 for Q5169 across 13 states, from $457.28 in Arizona to $579.22 in Arkansas.

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

States publishing
13
National median
$519.48units vary by state
Lowest
$457.28Arizona
Highest
$579.22Arkansas

What does Medicaid pay for Q5169?

13 state Medicaid programs publish a fee-for-service rate for Q5169 at the physician psychologist level. The national median is $519.48 (units differ between states). Arkansas pays the most, $579.22, and Arizona the least, $457.28, a 1.3x spread.

Q5169 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 13 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Arkansas Source · since 2026-08-10$579.22——Not classified—
2Nebraska Source · since 2026-07-01$542.64——Plans negotiate; applies out of network—
3West Virginia Source · since 2026-10-01$519.480.5 MG—Plans negotiate; applies out of network—
6Wisconsin Source · since 2026-10-01$519.48——Plans negotiate; applies out of network—
7Kansas Source · since 2026-10-01$519.48——Plans must pay at least this—
8South Dakota Source · since 2026-10-01$519.48——Not classified—
12Illinois Source · since 2026-07-01$472.62——Plans negotiate; applies out of network—
13Arizona Source · since 2026-08-01$457.28——Plans negotiate; applies out of network—
See all 13 states for Q5169 — start free

5 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

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; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track Q5169 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.

Frequently asked questions

What does Medicaid pay for Q5169?

It depends on the state. Of the 13 states with a published fee-for-service rate, the median is $519.48. Arkansas pays the most ($579.22) and Arizona the least ($457.28).

Which state pays the highest Medicaid rate for Q5169?

Arkansas, at $579.22, effective 2026-08-10.

Do managed-care plans pay the same rate for Q5169?

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.