Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for J1428. 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
$64.80 - $229.94
J1428 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arkansas | $128.00 | -- | -- | 2026 |
| Arizona | $160.00 | -- | -- | 2026 |
| California | $164.46 | -- | -- | 2026 |
| District of Columbia | $80.00 | -- | Required | 2022 |
| Iowa | $162.05 | -- | -- | 2022 |
| Illinois | $148.83 | -- | -- | 2026 |
| Indiana | $168.00 | -- | Required | 2018 |
| Kansas | $160.00 | -- | -- | 2021 |
| Kentucky | $167.36 | -- | -- | 2026 |
| Michigan | $169.60 | -- | -- | 2026 |
| Minnesota | $64.80 | -- | Required | 2025 |
| Mississippi | $167.51 | -- | -- | 2026 |
| Montana | $167.51 | -- | -- | 2026 |
| Nebraska | $170.88 | -- | -- | 2026 |
| New Hampshire | $160.00 | -- | Required | 2026 |
| New Jersey | $158.40 | -- | Not required | 2026 |
| New Mexico | $169.60 | -- | -- | 2025 |
| Oklahoma | $160.00 | -- | -- | 2026 |
| Rhode Island | $229.94 | -- | -- | 2026 |
| South Carolina | $161.60 | -- | -- | 2023 |
| Texas | $163.20* | -- | -- | 2018 |
| 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 J1428?
22 state Medicaid programs publish a fee-for-service rate for J1428 (injection, eteplirsen, 10 mg), ranging from $64.80 in Minnesota to $229.94 in Rhode Island. The full table on this page lists every publishing state's current rate.
Which state pays the most for J1428?
Rhode Island publishes the highest Medicaid rate for J1428 at $229.94. Minnesota publishes the lowest at $64.80.
Does J1428 require prior authorization under Medicaid?
5 of the 22 publishing states flag J1428 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".