Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for J0216. 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
$29/mo after the trial. Cancel anytime.
Publishing states
11
Median % of Medicare
--
Rate range
$2.05 - $7.42
J0216 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| California | $7.42 | -- | -- | 2026 |
| District of Columbia | $2.05 | -- | Not required | 2023 |
| Indiana | $2.54 | -- | -- | 2023 |
| Kansas | $2.42 | -- | -- | 2023 |
| Michigan | $2.57 | -- | -- | 2026 |
| Montana | $2.75 | -- | -- | 2026 |
| New Mexico | $2.60 | -- | -- | 2025 |
| South Carolina | $2.57 | -- | -- | 2023 |
| Utah | $2.42* | -- | Not required | 2024 |
| Washington | $2.57 | -- | -- | 2026 |
| Wisconsin | $2.57 | -- | -- | 2023 |
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
- J0013 - Esketamine, nasal spray, 1 mg
- 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
All 224 codes from J0013 to J0911 or every drugs code by number.
Frequently asked questions
How much does Medicaid pay for J0216?
11 state Medicaid programs publish a fee-for-service rate for J0216 (injection, alfentanil hydrochloride, 500 micrograms), ranging from $2.05 in District of Columbia to $7.42 in California. The full table on this page lists every publishing state's current rate.
Which state pays the most for J0216?
California publishes the highest Medicaid rate for J0216 at $7.42. District of Columbia publishes the lowest at $2.05.
Does J0216 require prior authorization under Medicaid?
No publishing state flags J0216 with a prior-authorization indicator on its fee schedule. Absence of a flag means the state publishes none, not that PA is never required - confirm through the state's provider manual.