J0270 Medicaid Rate by State

Injection, alprostadil, 1.25 mcg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)

12 state Medicaid programs publish a fee-for-service rate for J0270 (injection, alprostadil, 1.25 mcg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)), ranging from $0.35 in Washington to $11.52 in Nebraska.

Every state, kept current

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This page shows one representative rate per state for J0270. Full schedules include every locality, modifier, and age-band variant.

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Publishing states

12

Median % of Medicare

--

Rate range

$0.35 - $11.52

J0270 rates in every publishing state

StateMedicaid rate% of MedicarePrior authVintage
District of Columbia$1.92--Required2016
Iowa$10.19----2024
Idaho$0.50--Not required2025
Indiana$4.26----2026
Maine$0.67----2026
Nebraska$11.52----2026
New Mexico$0.71----2025
South Carolina$6.78----2026
Virginia$0.67----2012
Washington$0.35----2026
Wisconsin$0.67----2012
Wyoming$0.61----2021

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

All 224 codes from J0013 to J0911 or every drugs code by number.

Frequently asked questions

How much does Medicaid pay for J0270?

12 state Medicaid programs publish a fee-for-service rate for J0270 (injection, alprostadil, 1.25 mcg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)), ranging from $0.35 in Washington to $11.52 in Nebraska. The full table on this page lists every publishing state's current rate.

Which state pays the most for J0270?

Nebraska publishes the highest Medicaid rate for J0270 at $11.52. Washington publishes the lowest at $0.35.

Does J0270 require prior authorization under Medicaid?

1 of the 12 publishing states flag J0270 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".