Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for J0604. 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
13
Median % of Medicare
--
Rate range
$0.01 - $1.04
J0604 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $0.02 | -- | -- | 2026 |
| California | $0.01 | -- | -- | 2026 |
| District of Columbia | $0.87 | -- | Not required | 2018 |
| Iowa | $0.03 | -- | -- | 2024 |
| Kansas | $0.02 | -- | -- | 2023 |
| Massachusetts | $0.01 | -- | -- | 2026 |
| Mississippi | $0.17 | -- | -- | 2026 |
| Montana | $1.04 | -- | -- | 2026 |
| Nebraska | $0.02 | -- | -- | 2026 |
| New Hampshire | $0.02 | -- | Not required | 2026 |
| New Mexico | $0.95 | -- | -- | 2025 |
| South Carolina | $0.84 | -- | -- | 2023 |
| Washington | $0.01 | -- | -- | 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
- 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 J0604?
13 state Medicaid programs publish a fee-for-service rate for J0604 (cinacalcet, oral, 1 mg, (for esrd on dialysis)), ranging from $0.01 in Washington to $1.04 in Montana. The full table on this page lists every publishing state's current rate.
Which state pays the most for J0604?
Montana publishes the highest Medicaid rate for J0604 at $1.04. Washington publishes the lowest at $0.01.
Does J0604 require prior authorization under Medicaid?
No publishing state flags J0604 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.