Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for J0289. 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
33
Median % of Medicare
--
Rate range
$17.90 - $53.50
J0289 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $21.93 | -- | -- | 2026 |
| Arkansas | $32.03 | -- | -- | 2026 |
| Arizona | $22.78 | -- | -- | 2026 |
| California | $22.81 | -- | -- | 2026 |
| Connecticut | $26.66 | -- | -- | 2024 |
| District of Columbia | $20.72 | -- | Required | 2026 |
| Iowa | $51.60 | -- | -- | 2024 |
| Idaho | $17.90 | -- | Not required | 2026 |
| Illinois | $22.19 | -- | -- | 2026 |
| Indiana | $53.50 | -- | -- | 2022 |
| Kansas | $19.85 | -- | -- | 2026 |
| Kentucky | $20.72 | -- | -- | 2026 |
| Louisiana | $23.98 | -- | -- | 2026 |
| Massachusetts | $18.39 | -- | -- | 2026 |
| Maine | $19.85 | -- | -- | 2026 |
| Michigan | $19.85 | -- | -- | 2026 |
| Minnesota | $19.84 | -- | -- | 2026 |
| Mississippi | $22.81 | -- | -- | 2026 |
| Montana | $20.72 | -- | -- | 2026 |
| Nebraska | $19.84 | -- | -- | 2026 |
| New Hampshire | $50.95 | -- | Not required | 2026 |
| New Jersey | $34.34 | -- | Not required | 2026 |
| New Mexico | $23.98 | -- | -- | 2025 |
| Oklahoma | $19.85 | -- | -- | 2026 |
| Rhode Island | $20.77 | -- | -- | 2026 |
| South Carolina | $19.85 | -- | -- | 2026 |
| Texas | $22.62* | -- | -- | 2026 |
| Utah | $19.85* | -- | Not required | 2026 |
| Virginia | $19.84 | -- | -- | 2026 |
| Vermont | $20.41 | -- | -- | 2026 |
| Washington | $19.85 | -- | -- | 2026 |
| Wisconsin | $19.85 | -- | -- | 2026 |
| Wyoming | $25.90 | -- | -- | 2022 |
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 J0289?
33 state Medicaid programs publish a fee-for-service rate for J0289 (injection, amphotericin b liposome, 10 mg), ranging from $17.90 in Idaho to $53.50 in Indiana. The full table on this page lists every publishing state's current rate.
Which state pays the most for J0289?
Indiana publishes the highest Medicaid rate for J0289 at $53.50. Idaho publishes the lowest at $17.90.
Does J0289 require prior authorization under Medicaid?
1 of the 33 publishing states flag J0289 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".