Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for J0013. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
- Full-schedule CSV export and state network lists
- Email alerts when a state changes its rates
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Publishing states
15
Median % of Medicare
--
Rate range
$4.94 - $17.07
J0013 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $15.98 | -- | -- | 2026 |
| California | $15.23 | -- | -- | 2026 |
| Iowa | $13.97 | -- | -- | 2026 |
| Illinois | $4.94 | -- | -- | 2026 |
| Indiana | $16.78 | -- | -- | 2026 |
| Kansas | $15.98 | -- | -- | 2026 |
| Michigan | $15.79 | -- | -- | 2026 |
| Minnesota | $14.90 | -- | Required | 2026 |
| Mississippi | $15.98 | -- | -- | 2026 |
| Nebraska | $17.07 | -- | -- | 2026 |
| New Hampshire | $15.98 | -- | Not required | 2026 |
| South Carolina | $15.73 | -- | -- | 2026 |
| Texas | $8.15* | -- | -- | 2026 |
| Washington | $15.22 | -- | -- | 2026 |
| Wisconsin | $14.90 | -- | -- | 2026 |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * are representative published variants or methodology-derived rates. "--" in the prior-auth column means the state publishes no PA flag.
Related drugs codes
- J0120 - Injection, tetracycline, up to 250 mg
- J0121 - Injection, omadacycline, 1 mg
- J0122 - Injection, eravacycline, 1 mg
- J0129 - Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)
- J0130 - Injection abciximab, 10 mg
- J0131 - Injection, acetaminophen, not otherwise specified,10 mg
- J0132 - Injection, acetylcysteine, 100 mg
- J0133 - Injection, acyclovir, 5 mg
All 224 codes from J0013 to J0911 or every drugs code by number.
Frequently asked questions
How much does Medicaid pay for J0013?
15 state Medicaid programs publish a fee-for-service rate for J0013 (esketamine, nasal spray, 1 mg), ranging from $4.94 in Illinois to $17.07 in Nebraska. The full table on this page lists every publishing state's current rate.
Which state pays the most for J0013?
Nebraska publishes the highest Medicaid rate for J0013 at $17.07. Illinois publishes the lowest at $4.94.
Does J0013 require prior authorization under Medicaid?
1 of the 15 publishing states flag J0013 as requiring prior authorization (always or conditionally) on their fee schedules. States without a flag publish no PA indicator for this code - that means "not published", not "no PA required".