S0136 Medicaid reimbursement rate by state (2026)
Clozapine, 25 mg. Medicaid pays a median of $0.74 for S0136 across 5 states, from $0.02 in Washington to $175.52 in New Mexico.
- States publishing
- 5
- National median
- $0.74units vary by state
- Lowest
- $0.02Washington
- Highest
- $175.52New Mexico
What does Medicaid pay for S0136?
5 state Medicaid programs publish a fee-for-service rate for S0136. The national median is $0.74 (units differ between states). New Mexico pays the most, $175.52, and Washington the least, $0.02, a 8776.0x spread.
S0136 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 5 states with every variant, modifier and effective date.
Frequently asked questions
What does Medicaid pay for S0136?
It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $0.74. New Mexico pays the most ($175.52) and Washington the least ($0.02).
Which state pays the highest Medicaid rate for S0136?
New Mexico, at $175.52, effective 2025-01-01.
Do managed-care plans pay the same rate for S0136?
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.