Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for J0752. 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
22
Median % of Medicare
--
Rate range
$426.58 - $812.50
J0752 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arkansas | $426.58* | -- | -- | 2026 |
| Arizona | $426.58 | -- | -- | 2026 |
| California | $621.96 | -- | -- | 2026 |
| Connecticut | $623.15 | -- | -- | 2026 |
| District of Columbia | $623.15 | -- | Not required | 2026 |
| Idaho | $538.40 | -- | Not required | 2026 |
| Illinois | $605.17 | -- | -- | 2026 |
| Indiana | $617.27 | -- | -- | 2025 |
| Kansas | $620.91 | -- | -- | 2026 |
| Maine | $620.91 | -- | -- | 2026 |
| Michigan | $620.91 | -- | -- | 2026 |
| Mississippi | $621.96 | -- | -- | 2026 |
| Montana | $623.15 | -- | -- | 2026 |
| New Hampshire | $812.50 | -- | Not required | 2026 |
| New Jersey | $582.00 | -- | Not required | 2026 |
| Oklahoma | $620.91 | -- | -- | 2026 |
| Rhode Island | $463.85 | -- | -- | 2026 |
| Texas | $449.03* | -- | -- | 2025 |
| Utah | $620.91* | -- | Required | 2026 |
| Virginia | $620.90 | -- | -- | 2026 |
| Vermont | $426.58 | -- | -- | 2026 |
| Wisconsin | $620.91 | -- | -- | 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 J0752?
22 state Medicaid programs publish a fee-for-service rate for J0752 (oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)), ranging from $426.58 in Vermont to $812.50 in New Hampshire. The full table on this page lists every publishing state's current rate.
Which state pays the most for J0752?
New Hampshire publishes the highest Medicaid rate for J0752 at $812.50. Vermont publishes the lowest at $426.58.
Does J0752 require prior authorization under Medicaid?
1 of the 22 publishing states flag J0752 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".