Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for J1426. 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
$148.83 - $185.26
J1426 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $160.00 | -- | -- | 2026 |
| Arkansas | $182.40 | -- | -- | 2026 |
| Arizona | $160.00 | -- | -- | 2026 |
| California | $164.46 | -- | -- | 2026 |
| District of Columbia | $160.00 | -- | Required | 2022 |
| Iowa | $162.05 | -- | -- | 2023 |
| Illinois | $148.83 | -- | -- | 2026 |
| Indiana | $168.00 | -- | Required | 2021 |
| Kansas | $160.00 | -- | -- | 2021 |
| Kentucky | $166.19 | -- | -- | 2026 |
| Michigan | $169.60 | -- | -- | 2026 |
| Minnesota | $160.00 | -- | Required | 2026 |
| Mississippi | $166.20 | -- | -- | 2026 |
| Montana | $185.26 | -- | -- | 2026 |
| Nebraska | $170.88 | -- | -- | 2026 |
| New Hampshire | $160.00 | -- | Required | 2026 |
| New Jersey | $158.40 | -- | Not required | 2026 |
| New Mexico | $168.57 | -- | -- | 2025 |
| Oklahoma | $160.00 | -- | -- | 2026 |
| South Carolina | $161.60 | -- | -- | 2024 |
| Texas | $163.20* | -- | -- | 2022 |
| Utah | $160.00* | -- | Required | 2024 |
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 J1426?
22 state Medicaid programs publish a fee-for-service rate for J1426 (injection, casimersen, 10 mg), ranging from $148.83 in Illinois to $185.26 in Montana. The full table on this page lists every publishing state's current rate.
Which state pays the most for J1426?
Montana publishes the highest Medicaid rate for J1426 at $185.26. Illinois publishes the lowest at $148.83.
Does J1426 require prior authorization under Medicaid?
5 of the 22 publishing states flag J1426 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".