Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for J1413. 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
$32,004.90 - $3,648,000.00
J1413 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arkansas | $3,648,000.00 | -- | -- | 2026 |
| Arizona | $3,200,000.00 | -- | -- | 2026 |
| District of Columbia | $3,200,000.00 | -- | Required | 2024 |
| Illinois | $2,976,601.60 | -- | -- | 2026 |
| Indiana | $3,360,000.00 | -- | Required | 2024 |
| Michigan | $1,734,737.20 | -- | -- | 2026 |
| Minnesota | $3,200,000.00 | -- | Required | 2026 |
| Mississippi | $3,321,376.38 | -- | -- | 2026 |
| New Mexico | $3,337,544.74 | -- | -- | 2025 |
| South Carolina | $32,004.90 | -- | -- | 2026 |
| Texas | $3,264,000.00* | -- | -- | 2025 |
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 194 codes from J1000 to J1980 or every drugs code by number.
Frequently asked questions
How much does Medicaid pay for J1413?
11 state Medicaid programs publish a fee-for-service rate for J1413 (injection, delandistrogene moxeparvovec-rokl, per therapeutic dose), ranging from $32,004.90 in South Carolina to $3,648,000.00 in Arkansas. The full table on this page lists every publishing state's current rate.
Which state pays the most for J1413?
Arkansas publishes the highest Medicaid rate for J1413 at $3,648,000.00. South Carolina publishes the lowest at $32,004.90.
Does J1413 require prior authorization under Medicaid?
3 of the 11 publishing states flag J1413 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".