S0013 Medicaid reimbursement rates by state
Esketamine, nasal spray, 1 mg. 7 state Medicaid programs publish a fee-for-service rate for S0013 at the physician psychologist level. Rates run from $11.02 in Minnesota to $14.90 in Arizona, with a median of $14.19.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 7
- Median rate
- $14.19units vary by state
- Highest
- $14.90Arizona
- Medicare (non-facility)
- —not on the physician fee schedule
S0013 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 |
|---|---|---|---|---|---|---|
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $14.90since 2025-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Physicia |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $14.90since 2025-04-01 | — | — | Plans negotiate; applies out of network | — | PADL- Appendix A -Published Copy - April |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $14.62since 2024-10-01 | — | — | Paid by the state, outside plans | — | MDHHS PIHP/CMHSP Physician Injectable Dr |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $14.19since 2025-10-01 | — | — | Plans negotiate; applies out of network | — | Medi Cal Physician Administered Drug Rat |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $13.97since 2024-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $11.38since 2021-01-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Nurse Practiti |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $11.02since 2021-01-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule (Wayback capture 20250 |
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 S0013?
It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $14.19. Arizona pays the most ($14.90) and Minnesota the least ($11.02).
Which state pays the highest Medicaid rate for S0013?
Arizona, at $14.90, effective 2025-10-01.
Do managed-care plans pay the same rate for S0013?
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.