Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for J1569. 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
33
Median % of Medicare
--
Rate range
$31.65 - $91.67
J1569 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $45.31 | -- | -- | 2026 |
| Arkansas | $31.65 | -- | -- | 2026 |
| Arizona | $44.14 | -- | -- | 2026 |
| California | $49.08 | -- | -- | 2026 |
| Connecticut | $47.29 | -- | -- | 2026 |
| District of Columbia | $47.29 | -- | Not required | 2026 |
| Iowa | $81.76 | -- | -- | 2024 |
| Idaho | $40.86 | -- | Not required | 2026 |
| Illinois | $47.76 | -- | -- | 2026 |
| Indiana | $91.67 | -- | -- | 2025 |
| Kansas | $49.30 | -- | -- | 2026 |
| Kentucky | $47.29 | -- | -- | 2026 |
| Massachusetts | $38.31* | -- | -- | 2026 |
| Maine | $49.30 | -- | -- | 2026 |
| Michigan | $49.30 | -- | -- | 2026 |
| Minnesota | $49.30 | -- | -- | 2026 |
| Mississippi | $49.08 | -- | -- | 2026 |
| Montana | $47.29 | -- | -- | 2026 |
| North Carolina | $49.30 | -- | -- | 2026 |
| Nebraska | $49.30 | -- | -- | 2026 |
| New Hampshire | $87.31 | -- | Not required | 2026 |
| New Jersey | $59.17 | -- | Not required | 2026 |
| New Mexico | $46.46 | -- | -- | 2025 |
| Oklahoma | $49.30 | -- | -- | 2026 |
| Rhode Island | $47.16 | -- | -- | 2026 |
| South Carolina | $42.00 | -- | -- | 2023 |
| Texas | $47.80* | -- | -- | 2026 |
| Utah | $49.30* | -- | Required | 2026 |
| Virginia | $49.30 | -- | -- | 2026 |
| Vermont | $43.04 | -- | -- | 2026 |
| Washington | $49.30 | -- | -- | 2026 |
| Wisconsin | $49.30 | -- | -- | 2026 |
| Wyoming | $49.30 | -- | -- | 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 194 codes from J1000 to J1980 or every drugs code by number.
Frequently asked questions
How much does Medicaid pay for J1569?
33 state Medicaid programs publish a fee-for-service rate for J1569 (injection, immune globulin, (gammagard liquid/gammagard liquid erc), 500 mg), ranging from $31.65 in Arkansas to $91.67 in Indiana. The full table on this page lists every publishing state's current rate.
Which state pays the most for J1569?
Indiana publishes the highest Medicaid rate for J1569 at $91.67. Arkansas publishes the lowest at $31.65.
Does J1569 require prior authorization under Medicaid?
1 of the 33 publishing states flag J1569 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".